bluuebunny/crossref_metadata_2025 huggingface dataset:
Measuring Oxygen Access: lessons from health facility assessments in Nigeria
Authors: Graham Hamish R , Olojede Omotayo E , Bakare Ayobami A , Iuliano Agnese , Olatunde Oyaniyi , Isah Adamu , Osebi Adams , Ahmed Tahlil , Burgess Rochelle Ann , McCollum Eric D , Colbourn Tim , King Carina , Uchendu Obioma C , Falade Adegoke G
Published: April 2021

The COVID-19 pandemic has highlighted global oxygen system deficiencies and revealed gaps in how we understand and measure “oxygen access”. We present a case study on oxygen access from 58 health facilities in Lagos state, Nigeria. We found large differences in oxygen access between facilities (primary vs secondary, government vs private) and describe four key domains to consider when measuring oxygen access.

Use

8/58 (14%) of facilities had a functional pulse oximeter for detecting hypoxaemia (low blood oxygen level) and guiding oxygen care. Oximeters were typically located in outpatient clinics (12/27, 44%), paediatric ward (6/27, 22%), or operating theatre (4/27, 15%), not suitable for children, and infrequently used.

Availability

34/58 (59%) facilities had a functional source of oxygen available on the day of inspection, of which 31 (91%) facilities had it available in a single ward area, typically the operating theatre or maternity ward.

Cost

Oxygen was free to patients at primary health centres, when available, but expensive in hospitals and private facilities, with the median cost for 2 days oxygen 13000 ($36 USD) and 27500 ($77 USD) naira, respectively.

Patient access

No facilities were adequately equipped to meet minimum oxygen demands for patients. We were unable to determine the proportion of hypoxaemic patients who received oxygen therapy with available data.

We highlight the importance of a multi-faceted approach to measuring oxygen access that assesses access at the point-of-care, and ideally at the patient-level. We propose standard metrics to report oxygen access and describe how these can be integrated into routine health information systems and existing health facility assessment tools.

SUMMARY BOX

Oxygen access is poorly understood and the most commonly used metrics (e.g. presence of an oxygen source) do not correlate well with actual access to patients.

Pulse oximetry use is a critical indicator for the quality of oxygen services and may be a reasonable reflection of oxygen coverage to patients with hypoxaemia.

Oxygen, and pulse oximeter, availability must be assessed at the point-of-care in all major service delivery areas, as intra-facility oxygen distribution is highly inequitable.

Minimum functional requirements for oxygen sources must be assessed, as many oxygen concentrators and cylinders may be present without being in working order.
Human Taste Cells Express ACE2: a Portal for SARS-CoV-2 Infection
Authors: Doyle Máire E , Appleton Ashley , Liu Qing-Rong , Yao Qin , Mazucanti Caio Henrique , Egan Josephine M
Published: April 2021

Loss and changes in taste and smell are well-reported symptoms of SARS-CoV-2 infection. The virus targets cells for entry by high affinity binding of its spike protein to cell-surface angiotensin-converting enzyme-2 (ACE2). It was not known whether ACE2 is expressed on taste receptor cells (TRCs) nor if TRCs are infected directly. Using anin-situhybridization (ISH) probe and an antibody specific to ACE2, it seems evident that ACE2 is present on a subpopulation of specialized TRCs, namely, PLCβ2positive, Type II cells in taste buds in taste papillae. Fungiform papillae (FP) of a SARS-CoV-2+ patient exhibiting symptoms of COVID-19, including taste changes, were biopsied. Based on ISH, replicating SARS-CoV-2 was present in Type II cells of this patient. Therefore, taste Type II cells provide a portal for viral entry that predicts vulnerabilities to SARS-CoV-2 in the oral cavity. The continuity and cell turnover of the FP taste stem cell layer of the patient were disrupted during infection and had not fully recovered 6 weeks post symptom onset. Another patient suffering post-COVID-19 taste disturbances also had disrupted stem cells. These results indicate that a COVID-19 patient who experienced taste changes had replicating virus in their taste buds and that SARS-CoV-2 infection results in deficient stem cell turnover needed for differentiation into TRCs.
Bank loan covenants, accrual quality and firms’ information environment
Authors: Chen Chao‐Jung , He Wen , Lu Chien‐Ju , Yu Xin
Published: April 2021

We examine whether initiations of bank loans with financial covenants motivate banks to monitor borrowers’ accounting practice and result in a higher quality of reported accruals and a better information environment for firms. We document that, relative to loans without financial covenants, loans with financial covenants lead to an improvement in accrual quality measured by the extent to which accruals can be mapped into cash flows. The effect of loan covenants on accrual quality is stronger when external monitoring by non‐bank stakeholders (i.e., institutional investors and financial analysts) is weaker. Furthermore, initiations of bank loans with financial covenants are related to subsequent improvements in analysts’ information environment. The evidence supports the view that bank monitoring improves accounting quality.
Words with Consistent Diachronic Usage Patterns are Learned Earlier: A Computational Analysis Using Temporally Aligned Word Embeddings
Authors: Cassani Giovanni , Bianchi Federico , Marelli Marco
Published: April 2021

In this study, we use temporally aligned word embeddings and a large diachronic corpus of English to quantify language change in a data‐driven, scalable way, which is grounded in language use. We show a unique and reliable relation between measures of language change and age of acquisition (AoA) while controlling for frequency, contextual diversity, concreteness, length, dominant part of speech, orthographic neighborhood density, and diachronic frequency variation. We analyze measures of language change tackling both the change in lexical representations and the change in the relation between lexical representations and the words with the most similar usage patterns, showing that they capture different aspects of language change. Our results show a unique relation between language change and AoA, which is stronger when considering neighborhood‐level measures of language change: Words with more coherent diachronic usage patterns tend to be acquired earlier. The results support theories positing a link between ontogenetic and ethnogenetic processes in language.
Contrast‐enhanced ultrasound combined with augmented reality medical technology in the treatment of rabbit liver cancer with high‐energy focused knife
Authors: Na Fengyu , Wang Li , Wu Cuicui , Ding Yan
Published: April 2021

Augmented reality technology can enhance people's perception and interactive experience of real scenes due to its characteristics of fusion of virtual and real, and has become a popular technology in the field of computer science. This article mainly studies the application of contrast‐enhanced ultrasound combined with augmented reality medical technology in the treatment of rabbit liver cancer with high‐energy focused knife. Sixty healthy male New Zealand white rabbits were used in this study. Seldinger's method was used to superselective embolize the artery supplying tumor with the help of hepatic angiography, which can kill tumor cells to the greatest extent and reduce the damage to normal liver cells. At the same time, another assistant under the guidance of ultrasound inserted the temperature probe into the position 1 cm away from the microwave radiation source, and then started the microwave ablation (MWA) treatment. High intensity focused ultrasound (HIFU) treatment is carried out under general anesthesia, the breathing rhythm of patients is controlled by ventilator, the proper position is set before operation, the real‐time monitoring is carried out by ultrasound monitoring mediated by medium water, and the HIFU three‐dimensional scanning treatment system is used to accurately cover all tumor treatment areas from point to line and from line to surface, so as to kill tumor cells to the greatest extent. The data of each group were processed by SPSS17.0 statistical software, and the measurement data were expressed as mean ± SD. ANOVA analysis of variance was used to compare the differences among the groups, and LSD method was used to make pairwise comparison within the group. p < 0.05 was considered as having statistical difference. The growth rate of tumor was 56.1% and 60.3%, respectively. Contrast‐enhanced ultrasound combined with augmented reality medical technology provides a new way for the treatment of rabbit liver cancer.
Prevalence of the presystolic wave in echocardiography and its association with the extent of coronary artery disease in patients with chronic stable angina
Authors: Alimi Hedieh , Hamidi Fatemeh , Bigdelue Leila , Poorzand Hoorak , Ghaderi Fereshteh , Fazlinejad Afsoon , Muhebati Mohsen , Emadzadeh Maryam
Published: April 2021

Introduction

Since mortality and morbidity of coronary artery disease are high, there is a need for non‐invasive diagnostic methods for early diagnosis and prediction of ischemic heart disease (IHD) outcome. This study aimed to assess the relationship between angiographic findings, the Presystolic wave (PSW) and some of the ischemic related parameters in echocardiography of the patients with chronic stable angina.

Materials and methods

This cross‐sectional study was conducted on the patients with chronic angina pectoris who referred to a tertiary hospital for coronary angiography in Mashhad, Iran. Demographic and medical history of the patients, as well as echocardiography findings, including ejection fraction (EF), regional wall motion abnormalities (RWMA), PSW and diastolic function were recorded. Angiographic findings, including SYNTAX score were also assessed.

Results

A total of 220 patients (132 males and 88 females) with the mean age of 62.43 ± 11.40 years old participated in this study. The prevalence of PSW was 49.1%. The absence of the PSW was related to more RWMA (P =.002), and higher stages of left ventricular diastolic dysfunction (LVDD) (P =.029) and higher SYNTAX score (P =.001). There was a significant association between the absence of the PSW and EF categories, especially in severe LV systolic dysfunction (LVEF < 30%) (P =.001).

Conclusions

The findings of this study revealed that PSW is strongly associated with the SYNTAX score. The absence of the PSW may indicate patients at high‐risk clinical status (higher SYNTAX score, severe systolic dysfunction, more RWMA, and higher stages of LVDD).
Correcting cis‐trans‐transgressions in macromolecular structure models
Authors: Waibl Franz , Liedl Klaus R. , Rupp Bernhard
Published: April 2021

Many macromolecular X‐ray and cryo‐EM structure models deposited in the PDB contain biologically relevant small molecule ligands with unsaturated fatty acid acyl chains, whose cis‐trans stereochemistry is incorrect. The molecules are either not properly defined in their stereochemical restraint files, or the proper stereochemistry is neglected during model building. Often, the same molecules appear in deposited models in both isomeric configurations, one of which is almost always incorrect, and the use of the same moiety (HET) identifier and restraint files in model refinement is wrong. We present case studies of frequently occurring molecules and a compilation of identified cases of C‐C=C‐C cis‐trans geometry in the deposited structure models. Full listings of cis/trans torsion angles are provided for models with commonly occurring molecules to assist identification and correction of cis‐trans errors and prevent inadvertent use of incorrect models. Caveats for users, advice for modellers and suggestions for remediation efforts with a simple but effective restraint file modification are provided.
Modified recombinant human IgG1‐Fc is superior to natural intravenous immunoglobulin at inhibiting immune‐mediated demyelination
Authors: Baksmeier Christine , Blundell Pat , Steckel Julia , Schultz Verena , Gu Quan , Da Silva Filipe Ana , Kohl Alain , Linnington Chris , Lu Dongli , Dell Anne , Haslam Stuart , Wang Jiabin , Czajkowsky Dan , Goebels Norbert , Pleass Richard J.
Published: April 2021

Intravenous immunoglobulin (IVIG) is an established treatment for numerous autoimmune conditions. Although Fc fragments derived from IVIG have shown efficacy in controlling immune thrombocytopenia in children, the mechanisms of action are unclear and controversial. The aim of this study was to dissect IVIG effector mechanisms using further adapted Fc fragments on demyelination in an ex vivo model of the central nervous system–immune interface. Using organotypic cerebellar slice cultures (OSCs) from transgenic mice, we induced extensive immune‐mediated demyelination and oligodendrocyte loss with an antibody specific for myelin oligodendrocyte glycoprotein (MOG) and complement. Protective effects of adapted Fc fragments were assessed by live imaging of green fluorescent protein expression, immunohistochemistry and confocal microscopy. Cysteine‐ and glycan‐adapted Fc fragments protected OSC from demyelination in a dose‐dependent manner where equimolar concentrations of either IVIG or control Fc were ineffective. The protective effects of the adapted Fc fragments are partly attributed to interference with complement‐mediated oligodendroglia damage. Transcriptome analysis ruled out signatures associated with inflammatory or innate immune responses. Taken together, our findings show that recombinant biomimetics can be made that are at least two hundred‐fold more effective than IVIG in controlling demyelination by anti‐MOG antibodies.
Effect of music therapy on improving sleep quality in older adults: A systematic review and meta‐analysis
Authors: Chen Chia‐Te , Tung Heng‐Hsin , Fang Ching‐Ju , Wang Jiun‐Ling , Ko Nai‐Ying , Chang Ying‐Ju , Chen Yen‐Chin
Published: April 2021

Objectives

Poor sleep quality is a common issue among older adults; it can lead to a poor quality of life and impairments in cognitive function and physical health. This study aimed to conduct a systematic review and meta‐analysis of the effect of listening to music on sleep quality in older adults.

Design

Systematic review and meta‐analyses.

Setting

Five databases, including Embase, Ovid Medline, Cochrane Library, Scopus, and the Index to Taiwan Periodical Literature System, were searched to identify studies assessing the efficacy of music therapy in older adults aged 60 years and older published through February 20, 2021.

Participants

Adults aged 60 years and older.

Measurements

We searched English‐ and Chinese‐language studies of randomized control trials. All studies were reviewed by two independent investigators. The primary sleep outcome was the Pittsburgh sleep quality index. The Cochrane Collaboration tool was used to assess the risk of bias, and Review Manager 5.3 software was used to conduct the meta‐analysis.

Results

Five randomized control trials were included in the meta‐analysis. Older adults who listened to music experienced significantly better sleep quality than those who did not listen to music [mean difference (MD): −1.96, 95% CI −2.23 to −1.73, P = 0.003]. The subgroup analysis revealed that older adults who listened to sedative music obtained a more effective improvement in sleep quality than those who listened to rhythm‐centered music (MD: −2.35, 95% CI –3.59 to −1.10, P = 0.0002). Furthermore, listening to music for longer than 4 weeks (MD: −2.61, 95% CI −4.72 to −0.50, P = 0.02) was to be effective at improving sleep quality.

Conclusions

Music therapy is safe and easy to administer and can effectively improve sleep quality among older adults, particularly those listening to more sedative music for at least a four‐week duration.
Lower eyelid xanthelasma following hyaluronic acid filler injections to the tear troughs
Authors: Liu Annie , Kollipara Ramya , Hoss Elika , Goldman Mitchel P.
Published: April 2021

Introduction

Adverse effects from dermal fillers are uncommon. We report a case of filler‐induced xanthelasma at the bilateral infraorbital region in a 43‐year‐old woman after multiple injections of hyaluronic acid to correct tear trough depression.

Material and Methods

We report a case of a 43‐year‐old woman with a chief complaint of skin discoloration of the bilateral lower eyelids. Her history was significant for ten sessions of hyaluronic acid filler for tear trough deformity between December 2008 and May 2016. On clinical examination, she exhibited thin, soft, and yellow papules to her lower medial infraorbital hollows. A punch biopsy showed foamy histiocytes with a background of hypervascularization and focal extracellular lipid in the superficial dermis, consistent with xanthelasma.

Results

Xanthelasma was treated with multiple passes of Er:YAG laser (Sciton Contour TRL) with a 4 mm spot size, fluence 7.5 J/cm2, and ablate/coagulate 50/50 at 6 Hz until clearance occurred. The perilesional skin was treated with 1–2 passes, fluence 7.5 J/cm2, ablate/coagulate 50/0 to blend in the cosmetic unit. Six‐month follow‐up showed notable improvement of all lesions.

Discussion

There is a paucity of treatments described for filler‐induced xanthelasma reaction. While broad conclusions cannot be drawn from one case, our experience indicates that complete resolution can be achieved with Er:YAG ablation. We hypothesize that this laser is an optimal treatment, as it can vaporize the lipid contents while minimizing adverse effects, such as scars and hyperpigmentation.
Reconsidering the Optionality of Raising in Japanese Exceptional‐Case‐Marking Constructions
Authors: Takahashi Masahiko
Published: April 2021

This article examines two arguments for the optionality of raising in Japanese exceptional‐Case‐marking constructions and proposes that certain observations can be accounted for even if we assume that raising is obligatory. Specifically, I contend that the distributions of exceptionally Case‐markedwhnegative‐polarity items and of embedded adjuncts, both of which have been cited as evidence for the optionality of raising, can be reconciled with the obligatory‐raising analysis. I propose (i) that the distribution ofwhnegative‐polarity items obeys a condition defined in terms of Transfer domains and (ii) that A‐movement allows adjuncts to take a “free ride.” Some consequences for the licensing ofwhnegative‐polarity items and for free‐ride effects are also discussed.
Nucleoprotein‐enriched diet enhances protein synthesis pathway and satellite cell activation via ERK1/2 phosphorylation in unloaded rat muscles
Authors: Nakanishi Ryosuke , Tanaka Minoru , Maeshige Noriaki , Kondo Hiroyo , Roy Roland R. , Fujino Hidemi
Published: April 2021

New Findings

What is the central question of this study?

The purpose of this study was to determine whether the nucleotides in a nucleoprotein‐enriched diet could ameliorate the unloading‐associated decrease in soleus muscle mass and fibre size.

What is the main finding and its importance?

The results indicate that the nucleotides in the nucleoprotein‐enriched diet could ameliorate the unloading‐associated decrease in type I fibre size and muscle mass, most probably owing to the activation of protein synthesis pathways and satellite cell proliferation and differentiation via ERK1/2 phosphorylation. Thus, nucleotide supplementation appears to be an effective countermeasure for muscle atrophy.

Hindlimb unloading decreases both the protein synthesis pathway and satellite cell activation and results in muscle atrophy. Nucleotides are included in nucleoprotein and provide the benefits of increasing extracellular signal‐regulated kinase (ERK) 1/2 phosphorylation. ERK1/2 phosphorylation is also important in the activation of satellite cells, especially for myoblast proliferation and stimulating protein synthesis pathways. Therefore, we hypothesized that nucleotides in the nucleoproteins would ameliorate muscle atrophy by increasing the protein synthesis pathways and satellite cell activation during hindlimb unloading in rat soleus muscle. Twenty‐four female Wistar rats were divided into four groups: control rats fed a basal diet without nucleoprotein (CON), control rats fed a nucleoprotein‐enriched diet (CON+NP), hindlimb‐unloaded rats fed a basal diet (HU) or hindlimb‐unloaded rats fed a nucleoprotein‐enriched diet (HU+NP). HU for 2 weeks resulted in reductions in phosphorylation of p70S6K and rpS6, the numbers of myoblast determination protein (MyoD)‐ and myogenin‐ positive nuclei, type I muscle fibre size and muscle mass. Both CON+NP and HU+NP rats showed an increase in ERK1/2, phosphorylation of p70S6K and rpS6, and the numbers of MyoD‐ and myogenin‐positive nuclei compared with their basal diet groups. The NP diet also ameliorated the unloading‐associated decrease in type I muscle fibre size and muscle mass. The results indicate that the nucleotides in the nucleoprotein‐enriched diet could ameliorate the unloading‐associated decrease in type I fibre size and muscle mass, most probably owing to the activation of protein synthesis pathways and satellite cell proliferation and differentiation via ERK1/2 phosphorylation. Thus, nucleotide supplementation appears to be an effective countermeasure for muscle atrophy.
A guide to the literature of the finite rectangular well
Authors: Cameron Reed B.
Published: April 2021

The finite rectangular well (FRW) has been a staple of quantum mechanics texts and classes for decades and is the subject of a rich literature. Despite being a problem about which there would apparently be not much more to be said, the FRW continues to serve as a system for introducing students to various analytic techniques and has numerous connections to current technology and research. This paper gives a survey of past and recent FRW literature, with an emphasis on pedagogical contributions directed at graphical and analytic solutions for energy eigenvalues.
ACOUSTICAL STANDARDS NEWS
Authors: Blair-DeLeon Nancy A. , Struck Christopher J.
Published: April 2021

American National Standards (ANSI Standards) developed by Accredited Standards Committees S1, S2, S3, S3/SC 1, and S12 in the areas of acoustics, mechanical vibration and shock, bioacoustics, animal bioacoustics, and noise, respectively, are published by the Acoustical Society of America (ASA). In addition to these standards, ASA publishes a catalog of Acoustical American National Standards. To browse the latest copy of our catalog, visit our website at https://acousticalsociety.org/download-catalog/.

Comments are welcomed on all material in Acoustical Standards News.

This Acoustical Standards News section in JASA, as well as the National Catalog of Acoustical Standards and other information on the Standards Program of the Acoustical Society of America, are also available via the ASA Standards home page: https://acousticalsociety.org/acoustical-society-standards/.
Reliability of Alpine Ski Racing-Specific Field Test: The 80s-Slide-Test
Authors: Bottollier Valentin , Cross Matt R. , Coulmy Nicolas , Le Quellec Loïc , Prioux Jacques
Published: April 2021

Purpose: The purpose of this study was to determine the test–retest reliability of the 80s-slide-test in well-trained alpine ski racers. Methods: The sample consisted of 8 well-trained alpine ski racers (age = 17.8 [0.7] y old; height = 1.80 [0.09] m; body mass = 72.1 [9.5] kg) who performed a lab-based maximal graded test on cycle ergometer and three 80s-slide-tests in 4 separate sessions. The 80s-slide-test consisting of maximal push-offs performed for 80s on a 8-ft slide board. Oxygen uptake () and heart rate (HR) were recorded continuously. Blood lactate ([La]b) was determined immediately prerun, followed by 3 minutes postrun. Three minutes after the completion of the session, the subjects were asked to indicate their rate of perceived exertion using Borg scale ranging from 6 to 20. Total and every 10s mean push-offs number were assessed by camera. Typical errors of measurement, intraclass correlation coefficients, and smallest worthwhile change were calculated. Results: The 80s-slide-test showed strong reliability for total push-offs number, , , HRpeak, and HRmean. Δ[La]b, fatigue index, and the rate of perceived exertion were moderately reliable. Conclusion: The 80s-slide-test is a reliable test for well-trained alpine ski racers and can be used easily by trainers.
The Relationship Between Absolute and Relative Upper-Body Strength and Handcycling Performance Capabilities
Authors: Nevin Jonpaul , Smith Paul M.
Published: April 2021

Purpose: To explore the relationship between absolute and relative upper-body strength and selected measures of handcycling performance. Methods: A total of 13 trained H3/H4-classified male handcyclists (mean [SD] age 37 [11] y; body mass 76.6 [10.1] kg; peak oxygen consumption 2.8 [0.6] L·min−1; relative peak oxygen consumption 36.5 [10] mL·kg·min−1) performed a prone bench-pull and bench-press 1-repetition-maximum strength assessment, a 15-km individual time trial, a graded exercise test, and a 15-second all-out sprint test. Relationships between all variables were assessed using Pearson correlation coefficient. Results: Absolute strength measures displayed a large correlation with gross mechanical efficiency and maximum anaerobic power output (P = .05). However, only a small to moderate relationship was identified with all other measures. In contrast, relative strength measures demonstrated large to very large correlations with gross mechanical efficiency, 15-km time-trial velocity, maximum anaerobic power output, peak aerobic power output, power at a fixed blood lactate concentration of 4 mmol·L−1, and peak oxygen consumption (P = .05). Conclusion: Relative upper-body strength demonstrates a significant relationship with time-trial velocity and several handcycling performance measures. Relative strength is the product of one’s ability to generate maximal forces relative to body mass. Therefore, the development of one’s absolute strength combined with a reduction in body mass may influence real-world handcycling race performance.
Gender (Dis)Similarity in Mentorship Among Intercollegiate Coaches: Implications for Leader Development
Authors: Machida-Kosuga Moe
Published: April 2021

Mentoring has been identified as an important antecedent for coaches’ professional and leadership development. I examined how the gender composition of head coach and assistant coach mentorship moderates the relationship between the quality of mentorship and assistant coaches’ leadership skills. The participants were 239 pairs of assistant and head coaches in U.S. college sports. The assistant coaches assessed the quality of mentorship with their head coaches, while the head coaches assessed their assistant coaches’ leadership skills. Mentorship quality was generally related to assistant coaches’ leadership skills, yet the relationships were positive and significant for dyads that involve female head coaches and not significant for dyads that involve male head coaches. The results indicate that gender composition may need to be considered in increasing the effectiveness of coaches’ mentorship. The findings inform the current practices in the implementation of mentoring for coaches’ leader development.
Exploring order parameters and dynamic processes in disordered systems via variational autoencoders
Authors: Kalinin Sergei V. , Dyck Ondrej , Jesse Stephen , Ziatdinov Maxim
Published: April 2021

The local order parameter in a disordered system is explored with convolutional neural networks and variational autoencoder.
Groundwater residence time estimates obscured by anthropogenic carbonate
Authors: Seltzer Alan M. , Bekaert David V. , Barry Peter H. , Durkin Kathryn E. , Mace Emily K. , Aalseth Craig E. , Zappala Jake C. , Mueller Peter , Jurgens Bryant , Kulongoski Justin T.
Published: April 2021

In central California, irrigation seepage perturbs groundwater inorganic carbon chemistry and complicates radiocarbon dating.
Development of ferroelectric nematic fluids with giant-ε dielectricity and nonlinear optical properties
Authors: Li Jinxing , Nishikawa Hiroya , Kougo Junichi , Zhou Junchen , Dai Shuqi , Tang Wentao , Zhao Xiuhu , Hisai Yuki , Huang Mingjun , Aya Satoshi
Published: April 2021

Pearl-shaped polar molecules with high enough dipole moment enable the creation of the giant-ε ferroelectric nematics.
Effective Generation of Glucosylpiericidins with Selective Cytotoxicities and Insights into Their Biosynthesis
Authors: Liu Zengzhi , Xiao Fei , Cai Siqi , Liu Chunni , Li Huayue , Wu Ting , Jiang Yuechen , Wang Xin , Che Qian , Zhu Tianjiao , Li Dehai , Li Wenli
Published: April 2021

Numerous bioactive natural products are appended with sugar moieties and are often critical for their bioactivities. Glycosyltransferases (GTs) are powerful tools for the glycodiversification of natural products.
Presentation of motor neuron disease in a patient with weight loss and acute-on-chronic respiratory failure
Authors: Chan Tak Wai
Published: April 2021

A previously fit and well 72-year-old man was referred to the acute medical unit with acute shortness of breath and confusion. He had presented 6 months earlier to his General Practitioner with a 6-month history of weight loss and lethargy. Despite CT imaging and extensive blood tests, no cause was found. He was having ongoing outpatient investigations, including a respiratory review leading up to his admission; the deterioration in his condition also coincided with the implementation of the COVID-19 lockdown. On admission, he was found to be in acute-on-chronic type 2 respiratory failure; examination revealed scattered fasciculations. Further inpatient electromyography (EMG) and nerve conduction study (NCS) confirmed motor neuron disease (MND). This case highlighted the importance of considering neuromuscular causes for acute respiratory failure in acute presentations and demonstrated the challenges in the diagnosis of MND in those presenting atypically with non-specific symptoms and the limitations of remote consultations in complex cases.
Plasma heat shock protein response to euglycemia in type 2 diabetes
Authors: Atkin Alexander S , Moin Abu Saleh Md , Al-Qaissi Ahmed , Sathyapalan Thozhukat , Atkin Stephen L , Butler Alexandra E
Published: April 2021

Introduction

Glucose variability is associated with mortality and macrovascular diabetes complications. The mechanisms through which glucose variability mediates tissue damage are not well understood, although cellular oxidative stress is likely involved. As heat shock proteins (HSPs) play a role in the pathogenesis of type 2 diabetes (T2D) complications and are rapidly responsive, we hypothesized that HSP-related proteins (HSPRPs) would differ in diabetes and may respond to glucose normalization.

Research design and methods

A prospective, parallel study in T2D (n=23) and controls (n=23) was undertaken. T2D subjects underwent insulin-induced blood glucose normalization from baseline 7.6±0.4 mmol/L (136.8±7.2 mg/dL) to 4.5±0.07 mmol/L (81±1.2 mg/dL) for 1 hour. Control subjects were maintained at 4.9±0.1 mmol/L (88.2±1.8 mg/dL). Slow Off-rate Modified Aptamer-scan plasma protein measurement determined a panel of HSPRPs.

Results

At baseline, E3-ubiquitin-protein ligase (carboxyl-terminus of Hsc70 interacting protein (CHIP) or HSPABP2) was lower (p=0.03) and ubiquitin-conjugating enzyme E2G2 higher (p=0.003) in T2D versus controls. Following glucose normalization, DnaJ homolog subfamily B member 1 (DNAJB1 or HSP40) was reduced (p=0.02) in T2D, with HSP beta-1 (HSPB1) and HSP-70-1A (HSP70-1A) (p=0.07 and p=0.09, respectively) also approaching significance relative to T2D baseline levels.

Conclusions

Key HSPRPs involved in critical protein interactions, CHIP and UBE2G2, were altered in diabetes at baseline. DNAJB1 fell in response to euglycemia, suggesting that HSPs are reacting to basal stress that could be mitigated by tight glucose control with reduction of glucose variability.
Crisis within a crisis, COVID-19 knowledge and awareness among the Syrian population: a cross-sectional study
Authors: Mohsen Fatema , Bakkar Batoul , Armashi Humam , Aldaher Nizar
Published: April 2021

Objectives

To gauge specific knowledge around clinical features, transmission pathways and prevention methods, and to identify factors associated with poor knowledge to help facilitate outbreak management in Syria during this rapid global rise of the COVID-19 pandemic.

Design

Web-based cross-sectional survey.

Setting

This study was conducted in March 2020, nearly 10 years into the Syrian war crisis. The Arabic-language survey was posted on various social media platforms including WhatsApp, Telegram, Instagram and Facebook targeting various social groups.

Participants

A total of 4495 participants completed the survey. Participants with a history of COVID-19 infection, residing outside Syria or who did not fully complete the survey were excluded from the study. The final sample of 3586 participants (completion rate=79.8%) consisted of 2444 (68.2%) females and 1142 (31.8%) males.

Primary and secondary outcome measures

First, knowledge of COVID-19 in four areas (general knowledge; transmission pathways; signs and symptoms; prevention methods). Second, factors associated with poor knowledge.

Results

Of the 3586 participants, 2444 (68.2%) were female, 1822 (50.8%) were unemployed and 2839 (79.2%) were college educated. The study revealed good awareness regarding COVID-19 (mean 75.6%, SD ±9.4%). Multiple linear regression analysis correlated poor mean knowledge scores with male gender (β=−0.933, p=0.005), secondary school or lower education level (β=−3.782, p<0.001), non-healthcare occupation (β=−3.592, p<0.001), low economic status (β=−0.669, p<0.040) and >5 household members (β=−1.737, p<0.001).

Conclusion

This study revealed some potentially troubling knowledge gaps which underscore the need for a vigorous public education campaign in Syria. This campaign must reinforce the public’s awareness, knowledge and vigilance towards precautionary measures against COVID-19, and most importantly aid in controlling the worldwide spread of the disease.
Virtual care for prostate cancer survivorship: protocol for an evaluation of a nurse-led algorithm-enhanced virtual clinic implemented at five cancer centres across Canada
Authors: Pham Quynh , Hearn Jason , Bender Jacqueline L , Berlin Alejando , Brown Ian , Bryant-Lukosius Denise , Feifer Andrew H , Finelli Antonio , Gotto Geoffrey , Hamilton Robert , Rendon Ricardo , Cafazzo Joseph A
Published: April 2021

Introduction

Prostate cancer (PCa) is the most common cancer in Canadian men. Current models of survivorship care are no longer adequate to address the chronic and complex survivorship needs of patients today. Virtual care models for cancer survivorship have recently been associated with comparable clinical outcomes and lower costs to traditional follow-up care, with patients favouring off-site and on-demand visits. Building on their viability, our research group conceived the Ned Clinic—a virtual PCa survivorship model that provides patients with access to lab results, collects patient-reported outcomes, alerts clinicians to emerging issues, and promotes patient self-care. Despite the promise of the Ned Clinic, the model remains limited by its dependence on oncology specialists, lack of an autonomous triage algorithm, and has only been implemented among PCa survivors living in Ontario.

Methods and analysis

Our programme of research comprises two main research objectives: (1) to evaluate the process and cost of implementing and sustaining five nurse-led virtual PCa survivorship clinics in three provinces across Canada and identify barriers and facilitators to implementation success and (2) to assess the impact of these virtual clinics on implementation and effectiveness outcomes of enrolled PCa survivors. The design phase will involve developing an autonomous triage algorithm and redesigning the Ned Clinic towards a nurse-led service model. Site-specific implementation plans will be developed to deploy a localised nurse-led virtual clinic at each centre. Effectiveness will be evaluated using a historical control study comparing the survivorship outcomes of 300 PCa survivors enrolled in the Ned Clinic with 300 PCa survivors receiving traditional follow-up care.

Ethics and dissemination

Appropriate site-specific ethics approval will be secured prior to each research phase. Knowledge translation efforts will include diffusion, dissemination, and application approaches to ensure that knowledge is translated to both academic and lay audiences.
Knowledge of patient emotional health status: impact on clinical care in glaucoma and retinal services
Authors: Naufal Fahd , Gajwani Prateek , Medina Robert , Dutson Madison , Mariotti Silvio P , West Sheila K
Published: April 2021

Objective

Knowledge of a patient’s emotional health status and using patient-centred communication may be key to providing early intervention and referral to appropriate treatment/support services for ophthalmology patients. This study aims to determine if and how ophthalmologists use anxiety and depression scores to determine clinical care of patients with chronic eye disease.

Methods and analysis

This cross-sectional study included 10 ophthalmologists and a convenience sample of 100 of their patients (>18 years). The Patient Health Questionnaire (PHQ-9) for depression and the Generalised Anxiety Disorder (GAD-7) tool were administered to patients. Scores from these instruments were provided to ophthalmologists just prior to the clinic visit. After the visit, ophthalmologists were given a questionnaire to assess self-reported change in clinical practice and whether knowledge of scores impacted their communication style, treatment plan and follow-up protocol.

Results

Of these patients (mean age=63), 27% reported mild-moderate anxiety or depression as their worst score, while 2% reported suicidal thoughts; 20% reported neither anxiety nor depression. Ophthalmologists’ response to patients with mild or worse anxiety or depression was to change clinical approach (28%) and communication style (31%), both metrics increasing with severity of symptoms (Fisher’s exact p<0.05). None reported changing their choice of treatment or modifying follow-up protocols; referral to social work/psychiatry services was 60%, 3.7% and 0% for patients with moderately severe or worse, mild-to-moderate, or minimal scores, respectively.

Conclusion

Providing ophthalmologists with knowledge of the emotional health of their patients may change the clinical approach and referral pattern.
Intendedness of pregnancies and preconception contraceptive use in women of Swedish and non-European origins seeking emergency care in early pregnancy
Authors: Bergman Marcus , Gray Anna-Maria , Sollier Nina , Sjöstrand Markus , Kopp Kallner Helena
Published: April 2021

Introduction

Unintended pregnancies in Europe have been estimated to constitute 43% of all pregnancies, with the proportion in Sweden being unknown. In striving for equitable healthcare, increased knowledge about unintended pregnancies among women born outside Europe is needed. We aimed to estimate the proportion of unintended pregnancies in women born in Sweden compared with women born outside Europe in an unselected population seeking gynaecological emergency care in early pregnancy. Our secondary aim was to compare contraceptive use at the time of conception in unplanned pregnancies between women born in Sweden and women born outside Europe.

Methods

Pregnant women seeking gynaecological emergency care in early pregnancy at a tertiary hospital were asked to fill out a questionnaire in their native language. The questionnaire contained questions from the London Measure of Unplanned Pregnancy (LMUP) and questions regarding sociodemographic data, gynaecological health and previous contraception.

Results

Of 180 pregnancies, 66 were unintended (36.7%) according to the LMUP. Among patients born in Sweden, 49/129 (38.0%) of the pregnancies were unintended compared with 17/51 (33.3%) among patients born outside Europe (p=0.56). 86% of participants with unintended pregnancy did not use any form of contraception during the month of conception, with no difference between women born in Sweden and those born outside Europe.

Conclusions

Among women seeking gynaecological emergency care in early pregnancy, unintended pregnancies are common. Women with unintended pregnancies had low use of preconception contraceptives, which highlights a need for further interventions aimed at avoiding unintended pregnancies.
Recent advances in liver transplantation
Authors: Burke N Thomas , Maurice James B , Nasralla David , Potts Jonathan , Westbrook Rachel
Published: April 2021

Liver transplant is a life-saving treatment with 1-year and 5-year survival rates of 90% and 70%, respectively. However, organ demand continues to exceed supply, such that many patients will die waiting for an available organ. This article reviews for the general gastroenterologist the latest developments in the field to reduce waiting list mortality and maximise utilisation of available organs. The main areas covered include legislative changes in organ donation and the new ‘opt-out’ systems being rolled out in the UK, normothermic machine perfusion to optimise marginal grafts, a new national allocation system to maximise benefit from each organ and developments in patient ‘prehabilitation’ before listing. Current areas of research interest, such as immunosuppression withdrawal, are also summarised.
Risk stratification of adults with congenital heart disease during the COVID-19 pandemic: insights from a multinational survey among European experts
Authors: Ruperti-Repilado Francisco Javier , Tobler Daniel , Greutmann Matthias , Bouchardy Judith , Ladouceur Magalie , Dos-Subira Laura , Gallego Pastora , Gabriel Harald , Bouma Berto , Schwerzmann Markus
Published: April 2021

Objective

Adults with congenital heart disease (ACHD) may be at a higher risk of a fatal outcome in case of COVID-19. Current risk stratification among these patients relies on personal experience and extrapolation from patients with acquired heart disease. We aimed to provide an expert view on risk stratification while awaiting results from observational studies.

Methods

This study was an initiative of the EPOCH (European Collaboration for Prospective Outcome Research in Congenital Heart disease). Among nine European countries (Austria, Belgium, Denmark, France, Germany, Italy, the Netherlands, Spain and Switzerland), 24 experts from 23 tertiary ACHD centres participated in the survey. ACHD experts were asked to identify ACHD-specific COVID-19 risk factors from a list of potential outcome predictors and to estimate the risk of adverse COVID-19 outcomes in seven commonly seen patient scenarios.

Results

82% of participants did not consider all ACHD patients at risk of COVID-19 related complications. There was a consensus on pulmonary arterial hypertension, Fontan physiology and cyanotic heart disease as risk factors for adverse outcomes. Among different ACHD scenarios, a patient with Eisenmenger syndrome was considered to be at the highest risk. There was a marked variability in risk estimation among the other potential outcome predictors and ACHD scenarios.

Conclusions

Pulmonary arterial hypertension, Fontan palliation and cyanotic heart disease were widely considered as risk factors for poor outcome in COVID-19. However, there was a marked disparity in risk estimation for other clinical scenarios. We are in urgent need of outcome studies in ACHD suffering from COVID-19.
Application of retrotransposon-based Inter-SINE Amplified Polymorphism (ISAP) markers for the differentiation of common poplar genotypes
Authors: Reiche Birgit , Kögler Anja , Morgenstern Kristin , Brückner Marie , Weber Beatrice , Heitkam Tony , Seibt Kathrin M. , Tröber Ute , Meyer Matthias , Wolf Heino , Schmidt Thomas , Krabel Doris
Published: April 2021

On the basis of retrotransposon-insertion polymorphisms, molecular markers were developed for the identification and differentiation of poplar (Populus spp.) genotypes. For this purpose, short interspersed nuclear elements (SINEs) in the genome sequence of Populus tremula L. were identified and assigned to different SINE families. For families with high copy number and high identity values, primers were developed to amplify inter-SINE amplified polymorphisms (ISAPs) with polymerase chain reaction. The resulting fragments produce genotype-specific fingerprints. This molecular approach utilizes standard laboratory equipment and is therefore easy to use for the verification of plant material. We demonstrate the functionality of three distinct ISAP primer combinations in comparison with 10 simple sequence repeat markers to differentiate 23 poplar genotypes. Already by using a single ISAP primer combination, all genotypes could be clearly distinguished. Furthermore, the cluster analysis based on three primer combinations divided clones according to their genetic background into two subclusters (by a bootstrap value of 98). Our results clearly demonstrate the usability of ISAP markers to differentiate genotypes and trace progenies of poplar trees.
Quantum interference effects in Higgs boson pair-production beyond the standard model
Authors: Das Biswaranjan , Moretti Stefano , Munir Shoaib , Poulose Poulose
Published: April 2021

New physics frameworks like the next-to-minimal supersymmetric standard Model and the Next-to-2-Higgs-doublet Model contain three neutral CP-even Higgs bosons. It is possible for the heavier two of these states to have masses identical to each other, which can result in a sizeable quantum interference between their propagators in processes they mediate. For both these models, we study the impact of such interference on the pair-production of the lightest of the three scalars, which we identify with the observed 125 GeV Higgs boson, in the gluon-fusion channel at the large hadron collider (LHC). We find that the inclusion of these effects can substantially alter the cross section, compared to its value when they are ignored, for this process. Our results illustrate the importance of taking possible quantum interference effects into account not only when investigating the phenomenology of extended Higgs sectors at the future Run(s) of the LHC, but also when imposing its current exclusion bounds on the parameter spaces of these models.