bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of crowd support: home advantage in football is reduced during the Coronavirus disease (COVID-19) pandemic
Authors: Macedo-Rego Renato C.
Published: April 2022

As support from other people can influence human behaviour, one may ask how the absence of crowd attendance influences the performance of football (i.e., soccer) players. I address this question by contrasting matches of the Brazilian Championship (1st and 2nd Divisions) in 2019 and 2020, years in which crowd attendance was prohibited in order to fight the Coronavirus disease (COVID-19) pandemic. In the 1st Division, home advantage decreased from 2019 to 2020, as teams that used to play for larger crowds had lower performance at home in 2020. However, no decrease in home advantage occurred in the 2nd Division in the same period. One explanation for this difference is that the beneficial effects of crowd support are more effective in the 1st Division, where players are used to receiving support from larger crowds. Therefore, while fan support can influence the behaviour/performance of players, this may not always happen.
Comparative exploratory movements of two terrestrial isopods (suborder: Oniscidea), in response to humidity and availability of food
Authors: Gunawardana Sasindu L. , Larsen Karl W.
Published: April 2022

Unfavourable conditions within familiar environments may prompt organisms to make forays into other habitats, at least temporarily. This behaviour is in turn linked to key demographic processes such as immigration, emigration, and eventually, metapopulation dynamics. How such movements are triggered by environmental conditions (much less their interaction effects) has rarely been experimentally tested. To address this, we examined how environmental conditions (3 levels of food and 3 levels of humidity) within a microcosm affect the movements of two species of isopods (Armadillidium vulgare and Porcellio scaber) out of their familiar habitat. We used web-camera checkpoints to record the movements of individually marked animals as they conducted forays along corridors that lead to new, unused habitats. Thirty-six trials were run in total for each species, with each trial involving 16 animals (8 ♂♂, 8 ♀♀). Relatively unfavourable conditions of low humidity, low food levels, and their interaction prompted changes to all the foray metrics we measured. However, different levels of mobility and tolerance to desiccation between the two species also appeared linked to the degree of responses, e.g., Porcellio demonstrated a greater tendency to depart from familiar habitat under low humidity, possibly due to their superior mobility and greater susceptibility to desiccation. This study improves our understanding of how different environmental conditions act in concert to affect the exploratory movements away from familiar habitat, and how these responses differ even for closely-related species.
Reproductive plasticity in response to food source in the fungal-feeding nematode Bursaphelenchus okinawaensis
Authors: Fujimori Yuta , Ekino Taisuke , Shinya Ryoji
Published: April 2022

Organisms use various strategies to cope with fluctuating environments. Some organisms express different phenotypes in alternative conditions through a process known as ‘phenotypic plasticity’, which is presumably an evolutionary adaptation to environmental variation. Nematodes adapt to various environments; it has been suggested that phenotypic plasticity is a contributing factor in their high level of environmental adaptability. We investigated the reproductive plasticity in response to a food source in the fungal-feeding nematode, Bursaphelenchus okinawaensis. Bursaphelenchus okinawaensis is known to reproduce primarily as a self-fertilising hermaphrodite on a filamentous fungus and yeast; here, we showed that newly isolated SH3 strain hermaphrodites produced a small number of progenies (⩽9 progenies per hermaphrodite) on the yeast test plate, while they laid similar numbers of eggs to the SH1 strain on the fungus test plate. Subsequent sperm observation by 4′,6-diamidino-2-phenylindole (DAPI) revealed that SH3 hermaphrodites could produce only a small number of sperm on the yeast test plate. Some hermaphrodites did not produce any eggs, indicating that they had become females rather than hermaphrodites. These results showed that the hermaphrodite or female status of SH3 nematodes was a plastic character, dependent on the food stimulus. An intra-strain crossing test between SH1 and SH3 suggested that the reproductive plasticity was controlled by a single recessive gene. This study provided an insight into a novel type of phenotypic plasticity in nematodes.
Thirty Years after the Break-up of Yugoslavia
Authors: Kirn Gal
Published: April 2022

The contribution sheds a critical light on the thirty years since the break-up of socialist Yugoslavia. It presents three hypotheses for a critical reorientation of the 1989–91 sequence. Firstly, rather than seeing 1989 as the start of the longue durée of a democratic process, for Yugoslavia this trajectory was ‘realised’ as political chaos and ethnic wars in 1991. Secondly, criticising the chronological view of ‘post-socialism’, it posits post-socialism as having already emerged after 1965, marked by market reforms that ‘withered away’ socialism. Thirdly, and specific to the 1990s, in order to facilitate the transition to capitalism, a ‘primitive accumulation’ of memory and a high degree of violence unfolded, which actually dis-accumulated the socialist infrastructure and socialised means of (re)production. The post-Yugoslav transition proved a genuine ‘contribution’ to ‘making our country great again’: ethnically cleansed nation-states on the horizon of European peripheral capitalism. The contribution concludes on an affirmative note, pointing to the slow resurgence of the Left.
The European Court of Human Rights and the Emergence of Human Germline Genome Editing
Authors: Spaander Merel M.
Published: April 2022

The field of human germline genome editing (HGGE) offers a promising reproductive potential to prevent inheritance of genetic diseases, yet also opens the door to undesirable eugenics. This stirred the debate about the acceptability of HGGE in light of human rights, particularly human dignity. The European Convention of Human Rights (ECHR) and the European Court of Human Rights (ECtHR) use human dignity as a guiding principle. Therefore, this article examined the clinical implementation of HGGE in light of relevant case-law regarding Article 2 and Article 8 ECHR. The analysis illustrates that the ECtHR broadens the scope of artificial reproductive rights under Article 8, however, Contracting States of the Council of Europe can limit these rights and the accessibility to reproductive techniques, such as HGGE. The ECtHR remains elusive about the legal status of unborn life, but protection under Article 2 with the introduction of HGGE should not be ruled out.
Organizational Rifts within Egypt’s Muslim Brotherhood and the Question of Violence
Authors: Yaghi Mohammad , Ranko Annette
Published: April 2022

This article traces the rift within Egypt’s Muslim Brotherhood since the July 2013 military coup. It argues that the tensions within the Brotherhood that became public in early 2015 have led to the formation of two organizations within the movement, each with its own leadership, structure, and media outlets. The article contends that the split within the Brotherhood between the two camps—the pacifists and the revolutionists—is over leadership, legitimacy, and strategy. Furthermore, the article investigates whether the revolutionists have espoused the use of violence against al-Sisi regime. Its findings confirm that while the revolutionists do not adopt any of the violent actions against the regime, they tolerate the use of violence in the name of qisas, self-defense, and retaliation. These findings are based on a thorough review of the official statements of the revolutionary camp within the Brotherhood.
Witchcraft and Its Implications for Women Reconsidered
Authors: Bachmann Judith
Published: April 2022

In Africa, witchcraft as both a practice and concept is characterized by diversity. A number of places such as Nigeria hold a general suspicion that women are more likely to be witches. This gendered social practice has been studied in anthropology. However, African women’s reactions and interests regarding practices associated with witchcraft (identification, deliverance, healing etc.) have not been studied sufficiently. And in particular, women’s multi-religious backgrounds have often been ignored. This article argues that research on witchcraft in Africa carries a burden of epistemic violence. It has often left the ascription of witchcraft to women unquestioned and at the same time, overlooked women’s own diverse religious perspectives and the interplay of this with witchcraft belief. Based on fieldwork among the Yoruba in Nigeria, the article analyses how witchcraft is ascribed as female, how women are impacted by this and how they position themselves within this social practice. It discusses these gender dynamics as related to the effects of epistemic violence and agency. Results show that women participate in the production of witchcraft as an imagined exclusive female practice, yet their dealings with witchcraft also implicate agency and the possibility of socio-religious change.
Europe’s Foray Into the Indo-Pacific
Authors: Heiduk Felix
Published: April 2022

The term Indo-Pacific has enjoyed growing popularity for years as a geographical and strategic construct. Increasingly, the Indo-Pacific is not conceived merely as a geographical construct, but also as a vital alternative to the Chinese “Belt and Road” Initiative (bri). Conversely, Beijing views the debates over the Indo-Pacific as nothing more than an anti-Chinese containment strategy. Chinese criticism notwithstanding, the debate on the Indo-Pacific has gained traction within Europe, too. France promoted its own Indo-Pacific concept from 2018 onwards, followed by Germany in 2020 with their own Indo-Pacific Leitlinien (guidelines) that preceded the launch of the EU’s own Indo-Pacific strategy in 2021. To assess possible focus points of an emerging EU approach to the Indo-Pacific, this article evaluates strategic convergence and divergence between the so-called E2, France and Germany. It finds that Germany and France, despite their different role conceptions, converge with regard to their key objectives, planned initiatives and conceptualisations of regional order. The article also finds, however, that these contain, for the most part, very general declarations of interests and intent while also foregoing concrete strategic choices. It argues that any future EU approach to the Indo-Pacific is therefore likely to emerge around the least common denominator focus points, drawing on long-established EU approaches towards the Asia-Pacific, rather than a new, clear-cut EU approach to the Indo-Pacific.
International Relations Scholarship in Greece
Authors: Mikelis Kyriakos , Tsardanidis Charalambos
Published: April 2022

Drawing on Felix Grenier’s ‘Reflexive Studies on ir’ schema, this article offers a reconstruction of the search for a disciplinary identity in Greece, mainly through a combination of the geo-epistemic and historiographical perspectives. It begins with an overview of the field’s history and pre-history, followed by a section on the teaching and research framework and is then followed by a section emphasizing the state and status of theory. Since the 1980s, an increasing expansion in Greek ir has been signalled by a noticeable wave of departments devoted to international or regional studies as well as of research institutes. Thus, most of the relevant literature on ir is still focused on regional and thematic aspects of Greece’s foreign relations, with a fairly marginal theoretical impact. Despite theoretical arguments proposed by some Greek scholars on anarchy and sovereignty, a distinct ‘Greek/Hellenic’ school or approach of ir is hardly forthcoming.
Uses of the Concept of Human Dignity and the Dignification of Victims in Transitional Justice in Colombia
Authors: Rios Oyola Sandra Milena
Published: April 2022

The idea of human dignity appears extensively in Transitional Justice (tj); nevertheless, it has not received critical examination. Based on the insights from the Colombian tj, this article analyses the challenges and tensions in the operationalisation of the mandate to restore victims’ human dignity. It studies three pathways of dignification that explain victims’ different engagement with steps that intend to restore their dignity. One of these pathways is refusing to be part of a state-led process while perceiving the state as a perpetrator. The article follows a qualitative methodology based on interviews with victims, civil servants acting in different tj mechanisms, and scholars; observation of tj meetings and public events; and the review of relevant documentation. The article firstly explains the background of dignity in human rights law and constitutional law. Secondly, it describes how the mandate of victim dignification appears in the Colombian tj and explains its use in practice. Finally, it presents different pathways used for the dignification of victims.
Wood anatomy of the tribe Diosmeae, a large Cape lineage of Rutaceae
Authors: Akinlabi Funmilade M. , Kotina Ekaterina L. , Oskolski Alexei A.
Published: April 2022

The tribe Diosmeae (Rutaceae) encompasses circa 278 species classified in 11 genera: ten of them are shrubs endemic to the Cape Floristic Region (South Africa), while the only arborescent genus (two species) extends from South Africa to Tanzania. We examined the wood structure of 21 species representing nine genera of Diosmeae and analysed it with respect to their life form and climatic niches. Studied taxa share a suite of traits typical for the whole family: radial vessel multiples, simple perforation plates, minute alternate intervessel pits, distinctly bordered vessel-ray pits, non-septate libriform fibres, and — except for Empleurum — marginal axial parenchyma. However, unlike most Rutaceae, they also occasionally feature vessel-ray pits with reduced borders. Most of the studied species are very similar to each other in their wood structure and habit. The two exceptions are Calodendrum capense (the only canopy tree under study) and Empleurum unicapsulare (a large riparian shrub). The first differs from other species in having wider vessels, longer libriform fibres, prismatic crystals in ray cells and winged-aliform axial parenchyma (which may be plesiomorphic for the tribe); the latter is distinctive because it lacks growth rings and banded axial parenchyma. Analysing anatomy–climate relationship, we found that wood anatomy among shrubby Diosmeae relates to their size and environmental factors, rather than taxonomy. Particularly, the vessel grouping weakly increases with stricter water limitation along the gradient from a semi-arid winter-dry climate to a Mediterranean winter-wet climate.
Holy Disorientation: Innovative Ministry with Young Adults that Takes Risks,Builds Confidence, and Anticipates Failure
Authors: Douglass Katherine M.
Published: April 2022

When leading congregations through a process of innovation to faithfully engage young adults, should leaders prepare congregations for the inevitable experience of failure related to the risks they are taking? This paper provides an overview of the research aims of the Zoe Project, a summary and analysis of the findings related to the participating congregations, as well as, the coaches who were involved in the project. We found that as congregations risked innovative ministries with young adults as leaders, their confidence grew. For some, however, failed projects proved to be an overpowering experience leading them to drop out of the project, despite awareness that innovation includes the possibility of failure. Finally, the parable of the talents shows us that Jesus had similar concerns regarding investment, risk, and failure. This paper concludes with theological reflections on leadership in projects that distribute resources, encourage risk, and anticipate failure.
“Through bush, across desert and over mountains”
Authors: Kleynhans Evert
Published: April 2022

During the Second World War, the East African theatre was marked by extreme variations in terms of climate, terrain, communications, and disease ecology. The planning, scope and conduct of the Allied offensive operations in the theatre was largely determined by the physical environment. The deployment of the 1st South African Infantry Brigade (1 sa Bde) to East Africa occurred across three distinct operational environments – the deserts of north-eastern Kenya, the bush country of Somalia, and the mountains of Ethiopia. The distinct changes in the physical environment influenced the combat operations of 1 sa Bde, which alternated between highly mobile, combined arms, operations across favourable terrain to somewhat static operations dominated by infantry and artillery over exceedingly difficult terrain. This article investigates the varied combat operations of 1 sa Bde in East Africa, and critically reflects on the influence that the physical environment exerted on the unfolding South African offensive operations.
Early Secular Burials in 19th-Century Flemish Provincial Towns
Authors: Tyssens Jeffrey
Published: April 2022

In 19th-century Belgium, cemeteries and burials gave rise to a major conflict between the Catholic Church and different kinds of secular people in Belgium. While these confrontations are quite well known in large urban environments, far less research has been produced about their counterparts in small-town settings. This article studies the options secular people had in those ‘backwater’ contexts in the province of Antwerp from the first secular burials in the 1860s up to the turn of the century. Following Albert Hirschman’s ‘voice / exit / loyalty’-scheme, we focus upon the choices that could be made and who could make them within the framework of local power relations. We will show how the particularities of social integration (or the lack thereof) generated the profiles of the individuals best equipped to break with Church-dominated community rituals and help to enforce local funerary policy transformations.
‘Funerary Culture Wars’ in Late 19th- and Early 20th-Century Europe and the Case of the Brussels’ Freethought Movement
Authors: De Spiegeleer Christoph
Published: April 2022

This article explores how the control of religious authority over funerary culture became a contentious issue on a pan-European level during the course of the second half of the 19th century and the early 20th century. A comparative analysis of the conflicts around burial and cremation in various European nation-states highlights the two-dimensional character of these ‘funerary culture wars’. Freethinkers were radical players in these institutional and cultural conflicts as they challenged the tight grip of churches on the ‘death systems’ in their respective cities and countries. We will show how the institutional and cultural secularisation of funerary culture was not a universal and inevitable developmental trend but rather a historically variable and contingent outcome of social and political struggles around concrete change. We zoom in on the city of Brussels where freethinkers made new secular funerary practices very visible from the middle of the 19th century onwards.
Education of Migrant Children from Myanmar in Thai Government Schools
Authors: Arphattananon Thithimadee
Published: April 2022

At the dawn of the 1990s, Thailand began to accept migrant workers from neighboring countries, namely Myanmar, Laos and Cambodia to work in labor sectors to meet with the high demand for manpower due to rapid economic development. Thirty years since the early batches of migrant workers entered the country, the number of migrant workers steadily increased and reached 3.9 million in 2018. Among this number, approximately 390,015 were children. Around thirty-five percent of these children were enrolled in Thai government schools. As the government school is a place where government policy and national ideology are manifested, this paper explores the forms and effects of education provided in government schools to children of migrant workers from Myanmar. These issues are examined through the lens of how nation-states integrate migrants into their societies.
Post-socialism as an experience of distancing and dispossession in rural and transnational Estonia
Authors: Annist Aet
Published: April 2022

This article brings together two sets of data – from rural Estonia and the Estonian diaspora in the UK – to analyse the themes of dispossession and distancing. The article highlights links between the processes of Othering and the continuing significance of the concepts of socialism and post-socialism as explanatory in relation to emerging hierarchies related to the region. In Estonia, some people and regions still seem to bear the marks of state socialism and face symbolic dispossession, in particular, the rural regions. Rural Estonians experience social dispossession and distance from one another, as well as from their home regions by migrating. With migration to western Europe, people acquire opportunities for taking new control over their own image, thus enabling some renewed symbolic and social worth. However, in the case of the diaspora in the UK, the migrant setting demonstrates how the use of disparaging terminology linked to the post-socialist transformation travels beyond borders, and also how the symbolic dispossession of eastern Europeans arises from the stigma of post-socialism.
Childhood Abuse and Neglect, Exposure to Domestic Violence and Sibling Violence: Profiles and Associations With Sociodemographic Variables and Mental Health Indicators
Authors: Sharratt Kathryn , Mason Samantha J. , Kirkman Gillian , Willmott Dominic , McDermott Danielle , Timmins Susan , Wager Nadia M.
Published: April 2022

Research indicates substantial overlap between child abuse and neglect (CAN), exposure to domestic violence and sibling abuse, with multiple victimisation experiences conferring greater risk for adverse mental health outcomes than does exposure to a single subtype. The application of latent class analysis (LCA) to child maltreatment has gained momentum, but it remains the case that few studies have incorporated a comprehensive range of subtypes, meaning that real-life patterns in victimisation experiences cannot be accurately modelled. Based on self-report data from an ethnically diverse sample ( N = 2813) of 10–17 year olds in the United Kingdom, the current study used LCA to model constellations among nine types of maltreatment in the home (physical, emotional and sexual abuse; physical and emotional neglect; exposure to physical and verbal domestic violence, or a drug-related threat; and sibling violence). A four-class solution comprising of a low victimisation class (59.3% of participants), an emotional abuse and neglect class (19.0%), a high verbal domestic violence class (10.5%) and a maltreatment and domestic violence class (11.2%) provided the best fit for the data. Associations with sociodemographic variables were examined, revealing differences in the composition of the classes. Compared to the low victimisation class, participants in the verbal domestic violence class, emotional abuse and neglect class and especially the maltreatment and domestic violence class, reported higher symptoms of anxiety and depression and an increased likelihood of non-suicidal self-injury, suicide ideation and suicide attempt. The findings carry important implications for understanding patterns of child maltreatment, and the implications for preventative strategies and support services are discussed.
The effects of partisan framing on COVID-19 attitudes: Experimental evidence from early and late pandemic
Authors: Wichowsky Amber , Condon Meghan
Published: April 2022

Political polarization has dominated news coverage of Americans’ responses to the COVID-19 pandemic. In this research note, we report findings from two experimental studies, in which we present respondents with news stories about COVID-19 mitigation measures that emphasize partisan difference or accord. The stories present the same numeric facts about public opinion, but highlight either the partisan gap that existed at the time of the study, or the fact that large majorities of both Republicans and Democrats supported the measures at the time. Results from our first study, conducted late April 2020, show that a media frame drawing attention to shared concern across party lines produced a less polarized response to social-distancing restrictions than a frame that drew attention to partisan difference. Our findings suggest that the extensive media coverage about the red-blue divide in COVID-19 opinions reinforced partisan polarization. These results, however, did not replicate in a second study conducted much later in the pandemic. Qualitative data collected across the two studies demonstrate the degree to which polarization had rapidly become a dominant narrative in Americans’ thinking about COVID-19.
Preferential expansion of CD8+ CD19-CAR T cells postinfusion and the role of disease burden on outcome in pediatric B-ALL
Authors: Talleur Aimee C. , Qudeimat Amr , Métais Jean-Yves , Langfitt Deanna , Mamcarz Ewelina , Crawford Jeremy Chase , Huang Sujuan , Cheng Cheng , Hurley Caitlin , Madden Renee , Sharma Akshay , Suliman Ali , Srinivasan Ashok , Velasquez M. Paulina , Obeng Esther A. , Willis Catherine , Akel Salem , Karol Seth E. , Inaba Hiroto , Bragg Allison , Zheng Wenting , Zhou Sheng M. , Schell Sarah , Tuggle-Brown MaCal , Cullins David , Patil Sagar L , Li Ying , Thomas Paul G. , Zebley Caitlin , Youngblood Benjamin , Pui Ching-Hon , Lockey Timothy , Geiger Terrence L. , Meagher Michael M. , Triplett Brandon M. , Gottschalk Stephen
Published: April 2022

T cells expressing CD19-specific chimeric antigen receptors (CD19-CARs) have potent antileukemia activity in pediatric and adult patients with relapsed and/or refractory B-cell acute lymphoblastic leukemia (B-ALL). However, not all patients achieve a complete response (CR), and a significant percentage relapse after CD19-CAR T-cell therapy due to T-cell intrinsic and/or extrinsic mechanisms. Thus, there is a need to evaluate new CD19-CAR T-cell products in patients to improve efficacy. We developed a phase 1/2 clinical study to evaluate an institutional autologous CD19-CAR T-cell product in pediatric patients with relapsed/refractory B-ALL. Here we report the outcome of the phase 1 study participants (n = 12). Treatment was well tolerated, with a low incidence of both cytokine release syndrome (any grade, n = 6) and neurotoxicity (any grade, n = 3). Nine out of 12 patients (75%) achieved a minimal residual disease-negative CR in the bone marrow (BM). High disease burden (≥40% morphologic blasts) before CAR T-cell infusion correlated with increased side effects and lower response rate, but not with CD19-CAR T-cell expansion. After infusion, CD8+ CAR T cells had a proliferative advantage over CD4+ CAR T cells and at peak expansion, had an effector memory phenotype with evidence of antigen-driven differentiation. Patients that proceeded to allogeneic hematopoietic cell transplantation (AlloHCT) had sustained, durable responses. In summary, the initial evaluation of our institutional CD19-CAR T-cell product demonstrates safety and efficacy while highlighting the impact of pre-infusion disease burden on outcomes. This trial was registered at www.clinicaltrials.gov as #NCT03573700.
Desmopressin response depends on the presence and type of genetic variants in patients with type 1 and type 2 von Willebrand disease
Authors: Atiq Ferdows , Heijdra Jessica , Snijders Fleur , Boender Johan , Kempers Eva , van Heerde Waander L. , Maas Dominique P. M. S. M. , Krouwel Sandy , Schoormans Selene C. , de Meris Joke , Schols Saskia E. M. , van Galen Karin P. M. , van der Bom Johanna G. , Cnossen Marjon H. , Meijer Karina , Fijnvandraat Karin , Eikenboom Jeroen , Leebeek Frank W. G.
Published: April 2022

Patients with type 1 and type 2 von Willebrand disease (VWD) can be treated with desmopressin. Although a previous study has shown that the location of the causative VWF gene variant is associated with desmopressin response in type 1 VWD, the association between variants in the VWF gene and desmopressin response is not yet fully understood. Our primary aim was to compare desmopressin response in type 1 VWD patients with and without a VWF gene variant. Secondly, we investigated whether desmopressin response depends on specific VWF gene variants in type 1 and type 2 VWD. We included 250 patients from the Willebrand in the Netherlands study: 72 type 1 without a VWF gene variant, 108 type 1 with a variant, 45 type 2A, 16 type 2M, and 9 type 2N patients. VWF gene was analyzed with ion semiconductor sequencing and Multiplex Ligation-dependent Probe Amplification. Complete response to desmopressin was observed in all type 1 VWD patients without a variant, 64.3% of type 1 patients with a variant, and 31.3% of type 2 patients (P < .001). Despite a large interindividual variability in desmopressin response, patients with the same variant had comparable desmopressin responses. For instance, in 6 type 1 patients with exon 4 to 5 deletion, mean VWF activity at 1 hour after desmopressin was 0.81 IU/mL, with a coefficient of variation of 22.9%. In conclusion, all type 1 VWD patients without a VWF gene variant respond to desmopressin. In type 1 and type 2 VWD patients with a VWF variant, desmopressin response highly depends on the VWF gene variants.
Prevalence and burden of chronic cough in China: a national cross-sectional study
Authors: Huang Kewu , Gu Xiaoying , Yang Ting , Xu Jianying , Yang Lan , Zhao Jianping , Zhang Xiangyan , Bai Chunxue , Kang Jian , Ran Pixin , Shen Huahao , Wen Fuqiang , Chen Yahong , Sun Tieying , Shan Guangliang , Lin Yingxiang , Wu Sinan , Wang Ruiying , Shi Zhihong , Xu Yongjian , Ye Xianwei , Song Yuanlin , Wang Qiuyue , Zhou Yumin , Li Wen , Ding Liren , Wan Chun , Yao Wanzhen , Guo Yanfei , Xiao Fei , Lu Yong , Peng Xiaoxia , Xiao Dan , Bu Xiaoning , Zhang Hong , Zhang Xiaolei , An Li , Zhang Shu , Cao Zhixin , Zhan Qingyuan , Yang Yuanhua , Liang Lirong , Dai Huaping , Cao Bin , He Jiang , Chung Kian Fan , Wang Chen
Published: April 2022

Background

Chronic cough is a common complaint, but there are no population-based data on its burden in China. We determined the prevalence of chronic cough and its impact on health status in adults stratified by sex, age and the diagnosis of COPD or the presence of small airway dysfunction (SAD).

Methods

A representative sample of 57 779 Chinese adults aged 20 years or older was recruited and pulmonary function test was measured. Chronic cough was defined as cough lasting for >3 months in each year. Quality of life was assessed by the 12-item Short Form Health Survey (SF-12), and self-reported history of hospital visits was recorded.

Results

Chronic cough was found in 3.6% (95% CI 3.1–4.1) of Chinese adults, 2.4% (95% CI 1.9–3.1) of those aged 20–49 years and 6.0% (95% CI 5.3–6.8) of those aged 50 years or older. Individuals with chronic cough had an impaired physical component summary (PCS) score of the SF-12 (p<0.0001) and more emergency visits (p=0.0042) and hospital admissions (p=0.0002). Furthermore, the impact of chronic cough on PCS score was more significant in those aged 50 years or older, or with COPD (p=0.0018 or 0.0002, respectively), with the impact on hospital admission being more significant in those with COPD or with SAD (p=0.0026 or 0.0065, respectively).

Conclusions

Chronic cough is prevalent in China and is associated with a poorer health status, especially in individuals aged 50 years or older and those with the diagnosis of COPD or SAD.
Multiplex bacterial PCR in the bronchoalveolar lavage fluid of non-intubated patients with suspected pulmonary infection: a quasi-experimental study
Authors: Salina Anna , Schumann Desiree M. , Franchetti Léo , Jahn Kathleen , Purkabiri Kurosch , Müller Raphael , Strobel Werner , Khanna Nina , Tamm Michael , Stolz Daiana
Published: April 2022

Background

Early pathogen identification in pulmonary infection is crucial to guide antibacterial therapy and decrease length of hospital stay. We hypothesise that compared to conventional diagnostic methods, a multiplex bacterial polymerase chain reaction assay has a higher diagnostic yield in bronchoalveolar lavage (BAL) fluid and improved clinical outcomes in patients with suspicion of pulmonary infection.

Methods

A prospective, monocentric, quasi-experimental, observational study was carried out. Unselected patients with suspected pulmonary infection who underwent bronchoscopy with BAL were included in the study over a period of 1 year. In addition to conventional diagnostic methods, a multiplex PCR bacterial assay was performed in BAL on a 2 week on: 1 week off pre-determined schedule. No therapeutic recommendations were provided to the treating physician.

Results

605 cases were included, 54% of whom were immunosuppressed. Conventional diagnostic methods detected 56% of the bacteria evidenced by PCR. PCR failed to detect bacteria in 4% of the cases with a positive conventional diagnostic result. After bronchoscopy, 42% of the patients received antibacterial therapy for pulmonary infection for a median of 12 antibiotic days. There was no statistically significant difference in length of hospital stay (median 8versus8; p=0.839), antibiotic exposure (median 11versus14; p=0.362) or number of antibiotics prescribed (median 2versus2; p=0.595) between the two groups.

Conclusions

A multiplex bacterial PCR detected more bacteria in BAL fluid than conventional diagnostic methods. However, without a specific antibiotic stewardship approach and a clear understanding of the clinical implications of a positive or negative PCR result, the PCR results did not influence clinical outcomes.
Nonpharmaceutical interventions to prevent viral respiratory infection in community settings: an umbrella review
Authors: Zhao Hedi , Jatana Sukhdeep , Bartoszko Jessica , Loeb Mark
Published: April 2022

Background

Respiratory viruses pose an important public health threat to most communities. Nonpharmaceutical interventions (NPIs) such as masks, hand hygiene or physical distancing, among others, are believed to play an important role in reducing transmission of respiratory viruses. In this umbrella review, we summarise the evidence of the effectiveness of NPIs for the prevention of respiratory virus transmission in the community setting.

Observations

A systematic search of PubMed, Embase, Medline and Cochrane reviews resulted in a total of 24 studies consisting of 11 systematic reviews and meta-analyses, 12 systematic reviews without meta-analyses and one standalone meta-analysis. The current evidence from these data suggests that hand hygiene is protective against respiratory viral infection. The use of hand hygiene and facemasks, facemasks alone and physical distancing were interventions with inconsistent evidence. Interventions such as school closures, oral hygiene or nasal saline rinses were shown to be effective in reducing the risk of influenza; however, the evidence is sparse and mostly of low and critically low quality.

Conclusions

Studies on the effectiveness of NPIs for the prevention of respiratory viral transmission in the community vary in study design, quality and reported effectiveness. Evidence for the use of hand hygiene or facemasks is the strongest; therefore, the most reasonable suggestion is to use hand hygiene and facemasks in the community setting.
Three important short-chain fatty acids (SCFAs) attenuate the inflammatory response induced by 5-FU and maintain the integrity of intestinal mucosal tight junction
Authors: Yue Xi , Wen Sun , Long-kun Ding , Man Yan , Chang Sun , Min Zhang , Shuang-yu Li , Xin Qian , Jie Ma , Liang Wu
Published: April 2022

Background

5-Fluorouracil (5-FU) is a used chemotherapy drug for cancer, and its main side effect is intestinal mucositis which causes chemotherapy to fail. It was known that short-chain fatty acids (SCFAs) can inhibit immune cell release of various proinflammatory factors and inhibit excessive intestinal inflammation. However, the inhibitory effect of SCFAs on 5-FU-induced intestinal mucositis is still unclear.

Results

To simulate the effects of SCFAs on immune and intestinal epithelial cells, the cells (THP-1 cells and Caco-2 cells) were pretreated with sodium acetate (NaAc), sodium propionate (NaPc) and sodium butyrate (NaB), then inflammation was induced by 5-FU. The expressions of reactive oxygen species (ROS), Beclin-1, LC3-II, NF-κB p65, NLRP3 inflammasome, proinflammatory/anti-inflammatory cytokines and mucosal tight junction proteins were determined. In our results, the three SCFAs could inhibit ROS expressions, NLRP3, Caspase-1, IL-1β, IL-6, IL-18, Beclin-1 and LC3-II, when induced by 5-FU. In a 5-FU-induced chemoentermuctis mouse model, Lactobacillus rhamnoides can increase the concentrations of three SCFAs in faeces and increase the concentrations of IL-1β, IL-6 and IgA in serum, and decrease the expressions of NLRP3 and IL-17 in spleen cells. The expressions of ZO-1 and Occludin in intestinal mucosa were significantly increased.

Conclusions

These results indicated that the three SCFAs can effectively suppress the inflammation of THP-1 cells and Caco-2 cells and maintain tight junction integrity in intestinal mucosal epithelial cells.
Comparison of carotid atherosclerotic plaque characteristics between symptomatic patients with transient ischemic attack and stroke using high-resolution magnetic resonance imaging
Authors: Lu Mingming , Zhang Lichen , Yuan Fei , Peng Peng , Zhang Hongtao , Liu Shitong , He Yao , Cai Jianming , Zhao Xihai
Published: April 2022

Background

This study aimed to compare the characteristics of carotid plaques between patients with transient ischemic attack (TIA) and ischemic stroke using magnetic resonance (MR) imaging.

Methods

Patients with a recent ischemic stroke or TIA who exhibited atherosclerotic plaques of carotid arteries in the symptomatic sides determined by MR vessel wall imaging were recruited. The plaque morphology and compositions including intraplaque hemorrhage (IPH), lipid-rich necrotic-core (LRNC) and calcification were compared between TIA and stroke patients. Logistic regression was performed to relate the plaque characteristics to the types of ischemic events.

Results

A total of 270 patients with TIA or ischemic stroke were recruited. Stroke patients had a significantly higher prevalence of diabetes (42.2% vs. 28.2%, p = 0.021), greater mean wall area (35.1 ± 10.1 mm2 vs. 32.0 ± 7.7 mm2, p = 0.004), mean wall thickness (1.3 ± 0.2 mm vs. 1.2 ± 0.2 mm, p = 0.001), maximum normalized wall index (NWI)(63.9% ± 6.0% vs. 62.2% ± 5.9%, p = 0.023) and %volume of LRNC (9.7% ± 8.2% vs. 7.4% ± 7.9%, p = 0.025) in the carotid arteries compared to those with TIA. After adjustment for clinical factors, above characteristics of carotid arteries were significantly associated with the type of ischemic events. After further adjustment for maximum NWI, this association remained statistically significant (OR, 1.41; CI, 1.01–1.96; p = 0.041).

Conclusions

Ischemic stroke patients had larger plaque burden and greater proportion of LRNC in carotid plaques compared to those with TIA. This study suggests that ischemic stroke patients had more vulnerable plaques compared to those with TIA.
Airway management procedures in Swedish emergency department patients - a national retrospective study
Authors: Wilhelms Susanne B. , Wilhelms Daniel B.
Published: April 2022

Background

With the on-going debate about which specialty should be responsible for intubations in the emergency department in mind, the aim of this study was to describe the prevalence of endotracheal intubation and other airway management procedures in emergency department patients in Sweden.

Methods

All patients registered in the Swedish Intensive Care Registry with admission date from January 1 2013 until June 7 2018 and reported admission type “from the emergency department” or “emergency department” reported in the SAPS3 scoring were included. All patients missing codes for procedures were excluded.

Results

A total of 110,072 admissions from an emergency department to an ICU were registered during the study period. Of these, 41,619 admissions (37.8%) were excluded due to lack of codes for medical procedures. The remaining 68,453 admissions (62.2%) were included, and 31,888 emergency airway procedures (within 3 h from admission time to the intensive care unit) were registered. Invasive emergency airway procedures were the most common type of airway procedure (n = 23,446), followed by non-invasive airway procedures (n = 8377) and high-flow nasal cannula (n = 880). In 2017 a total of 4720 invasive emergency airway management procedures were registered.

Conclusions

The frequency of invasive airway management procedures in Swedish EDs is low. With approximately 1.9 million adult ED visits per year, this gives an estimated incidence of 2.4 invasive airway management procedures per thousand ED visits in 2017.

Trial registration

Not applicable.
Bayesian adaptive design for pediatric clinical trials incorporating a community of prior beliefs
Authors: Wang Yu , Travis James , Gajewski Byron
Published: April 2022

Background

Pediatric population presents several barriers for clinical trial design and analysis, including ethical constraints on the sample size and slow accrual rate. Bayesian adaptive design methods could be considered to address these challenges in pediatric clinical trials.

Methods

We developed an innovative Bayesian adaptive design method and demonstrated the approach as a re-design of a published phase III pediatric trial. The innovative design used early success criteria based on skeptical prior and early futility criteria based on enthusiastic prior extrapolated from a historical adult trial, and the early and late stopping boundaries were calibrated to ensure a one-sided type I error of 2.5%. We also constructed several alternative designs which incorporated only one type of prior belief and the same stopping boundaries. To identify a preferred design, we compared operating characteristics including power, expected trial size and trial duration for all the candidate adaptive designs via simulation when performing an increasing number of equally spaced interim analyses.

Results

When performing an increasing number of equally spaced interim analyses, the innovative Bayesian adaptive trial design incorporating both skeptical and enthusiastic priors at both interim and final analyses outperforms alternative designs which only consider one type of prior belief, because it allows more reduction in sample size and trial duration while still offering good trial design properties including controlled type I error rate and sufficient power.

Conclusions

Designing a Bayesian adaptive pediatric trial with both skeptical and enthusiastic priors can be an efficient and robust approach for early trial stopping, thus potentially saving time and money for trial conduction.
Development and validation of a prognostic nomogram for gallbladder cancer patients after surgery
Authors: Xu Xinsen , He Min , Wang Hui , Zhan Ming , Yang Linhua
Published: April 2022

Background

Gallbladder cancer is associated with late diagnosis and poor prognosis. Current study aims to develop a prognostic nomogram for predicting survival of gallbladder cancer patients after surgery.

Methods

Two large cohorts were included in this analysis. One consisted of 1753 gallbladder cancer patients from the Surveillance, Epidemiology, and End Results (SEER) database, and the other consisted of 239 patients from Shanghai Renji hospital. Significant prognostic factors were identified and integrated to develop the nomogram. Then the model was subjected to bootstrap internal validation and external validation.

Results

Univariate and multivariate analysis indicated that age, tumor histology, T-stage, N-stage and M-stage were significant prognostic factors, which were all included to build the nomogram. The model showed good discrimination, with a concordance index (C-index) of 0.724 (95% CI, 0.708–0.740), and good calibration. Application of the nomogram in the validation cohort still presented good discrimination (C-index, 0.715 [95% CI 0.672–0.758]) and good calibration. In the primary cohort, the C-index of the nomogram was 0.724, which was significantly higher than the Nevin staging system (C-index = 0.671; P < 0.001) and the 8th TNM staging system (C-index = 0.682; P < 0.001). In the validation cohort, the C-index of the nomogram was 0.715, which was also higher than the Nevin staging system (C-index = 0.692; P < 0.05) and the 8th TNM staging system (C-index = 0.688; P = 0.06).

Conclusions

The proposed nomogram resulted in more-accurate prognostic prediction for patients with gallbladder cancer after surgery.
Anti-LGI1 encephalitis recurring 3 years after the first episode: a case report
Authors: Fujita Hiroaki , Shioda Mukuto , Suzuki Keisuke
Published: April 2022

Background

Patients with antibodies against leucine-rich glioma-inactivated 1 (LGI1) present with limbic encephalitis, which is clinically characterized by a subacute disturbance of memory and behavior, often experience seizures. Most patients have a monophasic course, often with hyponatremia.

Case presentation

Herein, we report a 67-year-old Japanese male presenting with involuntary neck movement, abnormal behavior and apraxia. He was disoriented to time and place and occasionally unable to follow directions. Laboratory tests revealed the patient had hyponatremia (131 mEq/L). Cerebrospinal fluid (CSF) analysis showed that the cell count (1/μL) and protein content (33 mg/dL) were in the normal ranges. Electroencephalography showed transient theta bursts in the right frontal lobe. Magnetic resonance imaging (MRI) of the brain demonstrated hyperintensities in the medial temporal lobe and basal forebrain on fluid-attenuated inversion recovery (FLAIR) without gadolinium enhancement. Anti-voltage-gated potassium channel (Anti-VGKC) complex antibodies were below the reference level for limbic encephalitis. Although the diagnosis was unknown, intravenous methylprednisolone therapy was effective. Three years later, the patient began to speak incoherently and became disoriented to time. FLAIR MRI of the brain revealed recurrence in the left medial temporal lobe. The patient’s serum sodium level was 131 mEq/L. After intravenous methylprednisolone therapy, he regained alertness. A CSF sample stored at the time of the first attack was assayed and the patient was found to be LGI1-positive and CASPR-2-negative, and the diagnosis of anti-LGI1 encephalitis was made.

Conclusions

Monitoring serum sodium levels and the preserved samples from the first episode were useful for diagnosis.