bluuebunny/crossref_metadata_2025 huggingface dataset:
Unusual suspects: Glial cells in fertility regulation and their suspected role in polycystic ovary syndrome
Authors: Desroziers Elodie
Published: April 2022

Gonadotropin‐releasing‐hormone (GnRH) neurons sitting within the hypothalamus control the production of gametes and sex steroids by the gonads, therefore ensuring survival of species. As orchestrators of reproductive function, GnRH neurons integrate information from external and internal cues. This occurs through an extensively studied neuronal network known as the “GnRH neuronal network.” However, the brain is not simply composed of neurons. Evidence suggests a role for glial cells in controlling GnRH neuron activity, secretion and fertility outcomes, although numerous questions remain. Glial cells have historically been seen as support cells for neurons. This idea has been challenged by the discovery that some neurological diseases originate from glial dysfunction. The prevalence of infertility disorders is increasing worldwide, with one in four couples being affected; therefore, it remains essential to understand the mechanisms by which the brain controls fertility. The “GnRH glial network” could be a major player in infertility disorders and represent a potential therapeutic target. In polycystic ovary syndrome (PCOS), the most common infertility disorder of reproductive aged women worldwide, the brain is considered a prime suspect. Recent studies have demonstrated pathological neuronal wiring of the “GnRH neuronal network” in PCOS‐like animal models. However, the role of the “GnRH glial network” remains to be elucidated. In this review, I aim to propose glial cells as unusual suspects in infertility disorders such as PCOS. In the first part, I state our current knowledge about the role of glia in the regulation of GnRH neurons and fertility. In the second part, based on our recent findings, I discuss how glial cells could be implicated in PCOS pathology.
Topolects in Motion: Narrative Possibilities for Language Vitality among Mobile Chinese‐Canadians
Authors: Ward Shannon , Chow Fong Pui Alison , Ni Jingyi
Published: April 2022

This article examines the language autobiographies of 12 Chinese‐Canadians to address how topolects (Ch. fangyan)—spoken language varieties marking place‐based belonging—formulate identity once removed from their original places. We found that narrators located topolects in their pasts and homelands, while associating standard Mandarin with mobility and the future. We argue that, by associating topolects and standard Mandarin with contrasting times and places, narrators reformatted prevailing standard language ideologies from mainland China to rationalize experiences of linguistic exclusion. Despite pressures for language standardization, the narrative grounding of topolects in kinship chronotopes offers possibilities for maintaining diverse Chinese languages amidst mobility.
Connecting locally: An examination of the role of service providers in supporting the social inclusion of adults with intellectual disabilities in their neighbourhoods
Authors: Boland Geraldine , Guerin Suzanne
Published: April 2022

Article 19 of the UN Convention on the Rights of People with Disabilities calls for all people with disabilities to live independently and be included in their community. Adults with intellectual disabilities may live in neighbourhoods, but often have limited experience of social connectedness. This study aimed to examine the role of service provider organisations in supporting social inclusion in neighbourhoods of adults with intellectual disabilities. The understanding of social inclusion locally for adults with intellectual disabilities was explored and whether organisational policies (if any) had been drawn up to guide the support actions of staff. A mixed methods design was employed, with CEOs/service leaders of 40 service provider organisations completing an online survey. Follow‐up telephone interviews were completed with a randomised sample. Data were analysed using descriptive statistics and qualitative content analysis. Service leaders understood social inclusion to encompass purposeful engagement that moved beyond mere physical presence. Individuals having a sense of connection to place and belonging to people who live locally included fostering mutually supportive connections with neighbours. Equality of access to local services and supports were underscored. Active citizenship and service provider/staff supports for a socially included life were highlighted. Almost all service leaders rated the role of service providers at organisational/strategic level as important. However, their values and beliefs revealed contrasting views on the appropriate level of visibility of service providers when supporting individuals. Close to two‐thirds of service providers did not have an organisational policy regarding social inclusion in neighbourhoods. Developing specific service policies on social inclusion in neighbourhoods, based on the UNCRPD, and reflecting relevant national disability policies is proposed. This may enhance strategic planning and service providers decision‐making on targeted resource allocation. Further implications for policy, practice and research arising from this study are discussed.
The associations of parental COVID‐19 related worries, lifestyles, and insomnia with child insomnia during the COVID‐19 outbreak
Authors: Zhan Nalan , Zhang Yeqing , Xie Dongjie , Geng Fulei
Published: April 2022

The impacts of the Coronavirus Disease 2019 (COVID‐19) pandemic on sleep health have been studied extensively. However, little is known about sleep problems within the family system during the pandemic. This study aimed to examine the influence of the COVID‐19 pandemic on insomnia in both adults and children, and to explore whether parental COVID‐19 related worries, lifestyles, and insomnia were associated with child insomnia. A total of 1355 parent–child dyads (39.2% fathers, mean age 38.37 years, SD = 5.34; 52.7% boys, mean age 12.47 years, SD = 1.67) were recruited from Jiangxi province in China from 4 to 18 February 2020. Data on insomnia, COVID‐19 related worries, physical activity, and screen time were collected using online questionnaires. Path analysis showed that COVID‐19 related worries and screen time were positively associated with insomnia in both parents and children; while children's physical activity was negatively related to children's insomnia. Parents' insomnia, COVID‐19 related worries, physical activity, and screen time were positively associated with children's insomnia, COVID‐19 related worries, physical activity, and screen time, respectively. Bootstrap tests showed that parents' worries were positively associated with children's insomnia via parents' insomnia and children's worries; parents' physical activity was negatively associated with children's insomnia via children's physical activity, parents' screen time was positively associated with children's insomnia via parents' insomnia and children's screen time. Both parental and child sleep are affected by the pandemic. Parental insomnia, stress reaction, and lifestyles contribute to child insomnia. Child sleep health may be maintained or improved by family bonds, home exercise, and sleep schedules.
The Nash bargaining solution in labor market analysis
Authors: Skillman Gilbert L.
Published: April 2022

Two alternative strategic foundations have been identified for applications of the Nash bargaining solution in economic modelling. However, neither interpretation is consistent with treating “threat point” or disagreement payoffs as individual outside options, a salient feature of bargaining relationships in most labor market settings. This paper uses a matching and strategic bargaining model to examine the determination of bargaining power weights and threat points in the asymmetric Nash bargaining solution. The key result establishes a strategic foundation for applying this solution to market settings with endogenously determined outside options, and shows that bargaining weights depend on outside market conditions only when the matching prospects of one side of the market or the other are relatively high.
Nuclear envelope myopathy
Authors: Hayashi Yukiko K.
Published: April 2022

Nuclear envelope (NE) is a term of the structure surrounding each nucleus of the cell and has many important functions including maintaining chromatin organization. Mutations in the genes encoding NE proteins are known to cause several diseases including myopathies. The age at onset and clinical features of NE myopathy are quite variable, but careful management of associated cardiac symptoms including lethal arrhythmia and cardiomyopathy is critical for the prognosis. In this review, clinical characteristics of NE myopathies together with recent advances of their management is described.
Obesity‐related glomerulopathy: Current approaches and future perspectives
Authors: Martínez‐Montoro José Ignacio , Morales Enrique , Cornejo‐Pareja Isabel , Tinahones Francisco J. , Fernández‐García José Carlos
Published: April 2022

Obesity‐related glomerulopathy (ORG) is a silent comorbidity which is increasing in incidence as the obesity epidemic escalates. ORG is associated with serious health consequences including chronic kidney disease, end‐stage renal disease (ESRD), and increased mortality. Although the pathogenic mechanisms involved in the development of ORG are not fully understood, glomerular hemodynamic changes, renin‐angiotensin‐aldosterone system (RAAS) overactivation, insulin‐resistance, inflammation and ectopic lipid accumulation seem to play a major role. Despite albuminuria being commonly used for the non‐invasive evaluation of ORG, promising biomarkers of early kidney injury that are emerging, as well as new approaches with proteomics and metabolomics, might permit an earlier diagnosis of this disease. In addition, the assessment of ectopic kidney fat by renal imaging could be a useful tool to detect and evaluate the progression of ORG. Weight loss interventions appear to be effective in ORG, although large‐scale trials are needed. RAAS blockade has a renoprotective effect in patients with ORG, but even so, a significant proportion of patients with ORG will eventually progress to ESRD despite therapeutic efforts. It is noteworthy that certain antidiabetic agents such as sodium‐glucose cotransporter 2 inhibitors (SGLT2i) or glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) could be useful in the treatment of ORG through different pleiotropic effects. In this article, we review current approaches and future perspectives in the care and treatment of ORG.
Effect of Photobiomodulation Therapy on Differentiation of Mesenchymal Stem Cells Derived from Impacted Third Molar Tooth into Neuron‐like Cells
Authors: Mohammadi Farnoush , Bahrami Naghmeh , Nazariyan Mahya , Mohamadnia Abdolreza , Hakimiha Neda , Nazariyan Abolfazl
Published: April 2022

Peripheral nerve damages are among the most important consequences of dental and maxillofacial procedures. Tissue engineering using mesenchymal stem cells (MSCs) is a promising method to manage such injuries. Moreover, photobiomodulation therapy (PBMT) can enhance this treatment. The present study aimed to investigate the effect of PBMT on differentiation of MSCs derived from dental follicle (DF) into neurons. MSCs were isolated from an impacted tooth follicle by digestion method. The stem cells were cultured, and differentiated into neurons. The cells received two sessions of PBMT with 810 or 980 nm diode laser (100 mW, 4 J cm−2) in either DMEM or neural inductive medium. Phenotypic characterization of the cells was determined using flow cytometry. In addition, β‐tubulin and MAP2 genes expression level changes were analyzed using RT‐PCR and western blot technique. After 14 days, flow cytometry analysis confirmed the mesenchymal nature of cells. RT‐PCR and western blot affirmed the expression of β‐tubulin and MAP2 genes and proteins respectively. PBMT with both wavelengths significantly increased β‐tubulin and MAP2 expression in neural inductive medium with highest expression mean in 980 nm group. PBMT with 810 and 980 nm lasers could be a promising adjunctive method in differentiation of DF‐originated MSCs into neural cells.
Elucidating connections between the strigolactone biosynthesis pathway, flavonoid production and root system architecture in Arabidopsis thaliana
Authors: Richmond Bethany L. , Coelho Chloe L. , Wilkinson Helen , McKenna Joseph , Ratchinski Pélagie , Schwarze Maximillian , Frost Matthew , Lagunas Beatriz , Gifford Miriam L.
Published: April 2022

Strigolactones (SLs) are the most recently discovered phytohormones, and their roles in root architecture and metabolism are not fully understood. Here, we investigated four MORE AXILLARY GROWTH (MAX) SL mutants in Arabidopsis thaliana, max3‐9, max4‐1, max1‐1 and max2‐1, as well as the SL receptor mutant d14‐1 and karrikin receptor mutant kai2‐2. By characterising max2‐1 and max4‐1, we found that variation in SL biosynthesis modified multiple metabolic pathways in root tissue, including that of xyloglucan, triterpenoids, fatty acids and flavonoids. The transcription of key flavonoid biosynthetic genes, including TRANSPARENT TESTA4 (TT4) and TRANSPARENT TESTA5 (TT5) was downregulated in max2 roots and seedlings, indicating that the proposed MAX2 regulation of flavonoid biosynthesis has a widespread effect. We found an enrichment of BRI1‐EMS‐SUPPRESSOR 1 (BES1) targets amongst genes specifically altered in the max2 mutant, reflecting that the regulation of flavonoid biosynthesis likely occurs through the MAX2 degradation of BES1, a key brassinosteroid‐related transcription factor. Finally, flavonoid accumulation decreased in max2‐1 roots, supporting a role for MAX2 in regulating both SL and flavonoid biosynthesis.
Comparison of four strategies of ram management in a semen collection centre
Authors: Arrebola Francisco , Castillejo‐Lacalle Esteban , Borjas‐Muñoz Francisco , Querino‐Santiago Francisco J. , Redondo‐Cardador Francisca C. , Abecia José‑Alfonso
Published: April 2022

Thirty Merino rams were used to determine the effect of four management systems of rams on semen quality during the anoestrous season. Animals were divided into four groups: Artificial‐Photoperiod group (AP; n = 8), which were isolated from females and exposed to artificial long days (16 hr/d) from 1 Feb to 15 Mar; Natural‐Photoperiod (NP; n = 8), isolated from females and exposed to the natural photoperiod throughout the experiment; Oestrous‐Ewe group (EE; n = 7), housed in a pen adjacent to another pen that housed three ewes in oestrus, and Anestric‐Ewe group (AE; n = 7), housed adjacent to another pen that housed three ovariectomized ewes. From 20 Mar to the end of May (10 weeks), semen samples were collected weekly, and blood samples were collected to determine plasma testosterone concentrations. Mean plasma testosterone concentrations, ejaculate volume and reaction time were not affected either by treatment or week. There was a significant effect (p < .01) of ram treatment on sperm concentration, and both TM y PM, and their interaction, were significantly affected by group and week (p < .001). Rams exposed to ewes in oestrus presented the largest sperm concentration (p < .05) compared with the other three groups, although they had the lowest total and progressive motilities (p < .01). In conclusion, management strategy in spring affects semen quality of rams, with the presence of ewes in oestrus being the best plan to increase sperm concentration.
Flammability trajectories following destocking and forestation: a case study in the New Zealand high country
Authors: Lord Janice M. , Schloots Cara‐Lisa , Steel John B.
Published: April 2022

New forests can bring many benefits; however, public concern over wildfires can create a dilemma for restoration ecologists, managers, and policy makers advocating for forestation. In southern montane New Zealand, destocking following pastoral tenure review and forestation incentives have resulted in an increase in woody vegetation, raising concerns over fire risk. We used abundance‐weighted community flammability metrics to investigate changes in the flammability of montane grassland within Mahu Whenua Ecosanctuary following destocking, and the relative flammability of woody communities likely to establish naturally in this area. While woody species cover increased following destocking, a decrease in highly combustible graminoids and shrubs, and increased abundance of non‐flammable herbaceous species meant community flammability metrics reduced or showed no change. Woody communities that could potentially develop in the area varied substantially in structure and composition. Open, species‐rich, shrublands showed lower flammability metrics for both understorey and canopy than mixed dense shrubland/forests or species‐poor beech (Nothofagaceae) forests. For active forestation projects where fire is undesirable, a low‐flammability herbaceous understorey can reduce fire risk. Where desirable forest species are highly combustible but fire‐intolerant, e.g. New Zealand beech, fire risk could be reduced by maintaining buffer zones of low‐flammability vegetation or applying planting strategies such as nucleation that accelerate the development of closed canopy forest patches more likely to have moisture‐retentive ground layers. However, in historically burnt landscapes, additional information will be needed to define the wider pool of low‐flammability species appropriate for forestation programs.
Self‐Ruleand Intrastate Conflict Risk in Divided Societies: A Configurational Analysis of Consociational Institutions
Authors: Schulte Felix , Trinn Christoph
Published: April 2022

Scholars debate whether self‐rule is conducive to intrastate violence or peace. We argue that to resolve this problem the entire institutional setup of the state must be taken into account. Whereas the centripetalist view deemphasizes self‐rule as a vehicle of interethnic competition, consociationalism holds that it is the interplay of accommodative institutions, with segmental autonomy among them, that promotes intrastate peace. We test these rivaling expectations on a set of 556 subnational cases in 21 culturally fractionalized post‐war anocracies. We conduct a configurational risk analysis, which allows us to study self‐rule and conflict risk under various institutional arrangements. We find that the full consociational ‘package’ is indeed associated with a reduction of intrastate conflict risk. However, majoritarian configurations are equally associated with a risk reduction. In contrast, models that include self‐rule alone, or in combination with few other consociational elements, are consistently associated with an increase of conflict risk.
A Computer-Aided Design-Based Tolerance Analysis of Assemblies With Form Defects and Deformations of Nonrigid Parts
Authors: Tlija M. , Korbi A. , Louhichi B. , Tahan A.
Published: April 2022

Product assemblability and functional behavior are affected by geometric deviations. These deviations consist of manufacturing errors and part deformation defects caused by external loads. Taking the sources of deviations into account in tolerance analysis yields not only to more precise and reliable results but also to more complex tasks. In this context, the modeling of assembly parts with defects in a Digital MockUp (DMU) is quite promising. In this article, an integrated decision support tool is proposed to consider the causes of multiple defects, such as tolerances and external mechanical loads, in the tolerancing process. The worst-case concept and the small displacement torsor (SDT) are used to model rigid parts with orientation and positional defects. To model the part with form defects, random positions of each toleranced face points are determined using the Gaussian perturbation method (GPM) and considering the tolerance zone limits. A computer-aided design (CAD) method based on the B-spline interpolation allows the reconstruction of realistic surfaces of parts with form defects. Realistic configurations of nonrigid components subjected to external mechanical loads are determined using the finite element analysis (FEA). The realistic assembly configurations are performed by updating the mating constraints between planar and cylindrical parts. The proposed method considers all tolerance types on CAD models (positional, orientation, and form defects) and part deformations. The tolerance analysis is performed to check the compliance with the functional requirement (FR) and to correct the initial tolerance values. An industrial case study is used to validate the steps of the proposed tolerancing method.
A Reconfigurable Modular Fixture With Redundant Actuation
Authors: Lyu Shengnan , Xu Tianye , Ding Xilun , Xiao Hang
Published: April 2022

The rapid development of the automotive industry calls for large demands for fixtures with high modularity and full flexibility. A novel reconfigurable modular fixture is proposed in this article. The fixture, which provides high loading capacity, is designed based on the kinematic characteristics of dead point of linkage. The redundant actuation is introduced to increase the reliability of the mechanism. Kinematics of the loading mechanism is modeled and analyzed. The stiffness model of the mechanism is established through assembling the stiffness matrix of different links. Both kinematic parameters and structural parameters are optimized synchronously for obtaining the minimum deformations of the mechanism subject to constraints on volume and mass. The prototype of the developed fixture is designed and its comprehensive performance is analyzed. The modular design allows easier maintenance and replacement of the mechanism. The proposed design can also be utilized to other industrial applications.
Kinematics, Dynamics, and Experiments of n(3RRlS) Reconfigurable Series–Parallel Manipulators for Capturing Space Noncooperative Targets
Authors: Zhao Chong , Wang Ke , Zhao Haifeng , Guo Hongwei , Liu Rongqiang
Published: April 2022

The kinematics and dynamics of n(3RRlS) reconfigurable series–parallel manipulators (RSPMs) are the theoretical foundations for capturing noncooperative targets in space. In this study, a unified kinematic and dynamic modeling method of n(3RRlS) RSPMs is proposed based on geometric constraints, the vector method, recursive and inductive methods, and the principle of recursive virtual power, and the kinematic and dynamic modeling progress has clear concepts, unified format, and fast calculation. Then, the theoretical and simulated results of the 3RRlS reconfigurable series–parallel manipulator (RPM) and 3(3RRlS) RSPM are compared verifying the correctness of the derived kinematic and dynamic models. Finally, the reconfiguration, position accuracy, and deformation measurement experiments of the two-driven-unit 3RRlS RPM and 3(3RRlS) RSPM are carried out, and the results show that the 3(3RRlS) RSPM has the advantages of high folding ratio, motion uncoupling, and stiffness improvement.
Genetic elimination of rod/cone coupling reveals the contribution of the secondary rod pathway to the retinal output
Authors: Jin Nange , Tian Lian-Ming , Fahrenfort Iris , Zhang Zhijing , Postma Friso , Paul David L. , Massey Stephen C. , Ribelayga Christophe P.
Published: April 2022

In the retina, signals originating from rod and cone photoreceptors can reach retinal ganglion cells (RGCs)—the output neurons—through different pathways. However, little is known about the exact sensitivities and operating ranges of these pathways. Previously, we created rod- or cone-specific
Cx36
knockout (KO) mouse lines. Both lines are deficient in rod/cone electrical coupling and therefore provide a way to selectively remove the secondary rod pathway. We measured the threshold of the primary rod pathway in RGCs of wild-type mice. Under pharmacological blockade of the primary rod pathway, the threshold was elevated. This secondary component was removed in the
Cx36
KOs to unmask the threshold of the third rod pathway, still below cone threshold. In turn, the cone threshold was estimated by several independent methods. Our work defines the functionality of the secondary rod pathway and describes an additive contribution of the different pathways to the retinal output.
Loss of geomorphic diversity in shallow tidal embayments promoted by storm-surge barriers
Authors: Tognin Davide , Finotello Alvise , D’Alpaos Andrea , Viero Daniele P. , Pivato Mattia , Mel Riccardo A. , Defina Andrea , Bertuzzo Enrico , Marani Marco , Carniello Luca
Published: April 2022

Coastal flooding prevention measures, such as storm-surge barriers, are being widely adopted globally because of the accelerating rise in sea levels. However, their impacts on the morphodynamics of shallow tidal embayments remain poorly understood. Here, we combine field data and modeling results from the microtidal Venice Lagoon (Italy) to identify short- and long-term consequences of flood regulation on lagoonal landforms. Artificial reduction of water levels enhances wave-induced sediment resuspension from tidal flats, promoting in-channel deposition, at the expense of salt marsh vertical accretion. In Venice, we estimate that the first 15 closures of the recently installed mobile floodgates operated between October 2020 and January 2021 contributed to a 12% reduction in marsh deposition, simultaneously promoting a generalized channel infilling. Therefore, suitable countermeasures need to be taken to offset these processes and prevent significant losses of geomorphic diversity due to repeated floodgate closures, whose frequency will increase as sea levels rise further.
Epstein-Barr virus as a driver of multiple sclerosis
Authors: Sollid Ludvig M.
Published: April 2022

Accumulating evidence implicates Epstein-Barr virus (EBV) as an etiological factor in multiple sclerosis (MS). If EBV is a “driver” that causes antiviral immunity with associated autoimmune components rather than a “trigger” that unleashes self-perpetuating autoimmunity, then elimination of EBV would be a rational therapy for MS.
Platelets and mast cells say “HIAA” to welcome in neutrophils
Authors: Lichtman Andrew
Published: April 2022

Platelet- and mast cell–derived serotonin metabolite 5-HIAA binding to GPR35 mediates neutrophil recruitment to acute inflammatory sites.
Persistent omphalomesenteric duct and urachus presenting as an umbilical hernia
Authors: Rege Sameer Ashok , Saraf Vineeth Bhargav , Jadhav Mahesh
Published: April 2022

Vitellointestinal duct anomalies, although one of the most frequent malformations to be found (2%–3% in population), they are most unlikely to cause symptoms. A persistent Vitellointestinal duct can induce abdominal pain, bowel obstruction, intestinal haemorrhage and umbilical sinus, fistula or hernia which commonly occurs in children. Patent vitellointestinal duct or persistent omphalomesenteric duct is a very unusual congenital anomaly which occurs in 2% of the population related to the embryonic yolk stalk. Similarly, urachal anomalies remain a rare finding, with the most common being a cyst or sinus followed by patent urachus and rarely a urachal diverticulum. Presenting symptoms include periumbilical discharge, pain and a palpable mass.

Here, we report a case of an adult patient with patent vitellointestinal duct and urachus identified intraoperatively on diagnostic laparoscopy when being operated for umbilical hernia repair.
Ribociclib-induced extensive vitiligo-like lesions: possible pathomechanisms with clinical, dermoscopic and histological correlation
Authors: Anjaneyan Gopikrishnan , Keechilat Pavithran , Duraisamy Prasanna , Eapen Malini
Published: April 2022

Cyclin dependent kinase (CDK) 4/6 inhibitors are targeted agents which act on cyclin-D and these combined with hormonal therapy have been approved for the treatment of locally advanced or metastatic breast cancer. CDK 4/6 inhibitors have been found to have a tolerable adverse event profile; however, they have been associated with various dermatological adverse events. We report a case of ribociclib-induced vitiligo and discuss the clinical, dermoscopic and histological features with a review of the various possible pathomechanisms involved.
Barriers to uptake of referral eye care services among the elderly in residential care: the Hyderabad Ocular Morbidity in Elderly Study (HOMES)
Authors: Marmamula Srinivas , Kumbham Thirupathi Reddy , Modepalli Satya Brahmanandam , Chakrabarti Subhabrata , Keeffe Jill Elizabeth
Published: April 2022

Background

To report on the barriers to uptake of eye care services after referral in the elderly in ‘homes for the aged’ in Hyderabad, India.

Methods

Individuals aged ≥60 years were recruited from 41 ‘homes for the aged’ and were examined in the ‘make-shift’ clinics in homes. All participants who had vision impairment or needed further eye examination other than spectacles were referred to the higher centres for ‘free services’. Three months after the referral, the participants were interviewed and asked about the uptake of services, and their reasons for not attending.

Results

In all, 731/1182 (61.8%) participants were referred of which 375 (49.9%) attended. In multiple logistic regression, participants aged ≥80 years were less likely to utilise the services (OR 0.60; 95% CI 0.39 to 0.03). Similarly, the participants living in free homes (OR 3.53; 95% CI 2.15 to 5.79) and subsidised homes (OR 2.24: 95% CI 1.55 to 3.23) and those independently mobile had higher odds for uptake of services (OR 5.74; 95% CI 3.31 to 10.51). The major reasons for not availing the referral services were ‘lack of felt need’ reported by 136 (45.4%) participants followed by other health issues in 100 (33.4%) participants and non-consenting family members in 49 (16.4%) participants. In all, 14 (4.7%) participants gave other reasons.

Conclusions

The uptake of eye care services in the elderly in residential care remains poor despite the provision of services for free. Lack of felt need for services is the main reason for non-compliance to the referral for care. Counselling on the benefit of interventions could potentially improve referral compliance in this population.
FAST-IT:FindA SimpleTest —InTIA (transient ischaemic attack): a prospective cohort study to develop a multivariable prediction model for diagnosis of TIA through proteomic discovery and candidate lipid mass spectrometry, neuroimaging and machine learning—study protocol
Authors: Milton Austin G , Lau Stephan , Kremer Karlea L , Rao Sushma R , Mas Emilie , Snel Marten F , Trim Paul J , Sharma Deeksha , Edwards Suzanne , Jenkinson Mark , Kleinig Timothy , Noschka Erik , Hamilton-Bruce Monica Anne , Koblar Simon A
Published: April 2022

Introduction

Transient ischaemic attack (TIA) may be a warning sign of stroke and difficult to differentiate from minor stroke and TIA-mimics. Urgent evaluation and diagnosis is important as treating TIA early can prevent subsequent strokes. Recent improvements in mass spectrometer technology allow quantification of hundreds of plasma proteins and lipids, yielding large datasets that would benefit from different approaches including machine learning. Using plasma protein, lipid and radiological biomarkers, our study will develop predictive algorithms to distinguish TIA from minor stroke (positive control) and TIA-mimics (negative control). Analysis including machine learning employs more sophisticated modelling, allowing non-linear interactions, adapting to datasets and enabling development of multiple specialised test-panels for identification and differentiation.

Methods and analysis

Patients attending the Emergency Department, Stroke Ward or TIA Clinic at the Royal Adelaide Hospital with TIA, minor stroke or TIA-like symptoms will be recruited consecutively by staff-alert for this prospective cohort study. Advanced neuroimaging will be performed for each participant, with images assessed independently by up to three expert neurologists. Venous blood samples will be collected within 48 hours of symptom onset. Plasma proteomic and lipid analysis will use advanced mass spectrometry (MS) techniques. Principal component analysis and hierarchical cluster analysis will be performed using MS software. Output files will be analysed for relative biomarker quantitative differences between the three groups. Differences will be assessed by linear regression, one-way analysis of variance, Kruskal-Wallis H-test, χ2test or Fisher’s exact test. Machine learning methods will also be applied including deep learning using neural networks.

Ethics and dissemination

Patients will provide written informed consent to participate in this grant-funded study. The Central Adelaide Local Health Network Human Research Ethics Committee approved this study (HREC/18/CALHN/384; R20180618). Findings will be disseminated through peer-reviewed publication and conferences; data will be managed according to our Data Management Plan (DMP2020-00062).
How the reduction of working hours could influence health outcomes: a systematic review of published studies
Authors: Voglino Gianluca , Savatteri Armando , Gualano Maria Rosaria , Catozzi Dario , Rousset Stefano , Boietti Edoardo , Bert Fabrizio , Siliquini Roberta
Published: April 2022

Objectives

The health effects of work-time arrangements have been largely studied for long working hours, whereas a lack of knowledge remains regarding the potential health impact of reduced work-time interventions. Therefore, we conducted this review in order to assess the relationships between work-time reduction and health outcomes.

Design

Systematic review of published studies. Medline, PsycINFO, Embase and Web of Science databases were searched from January 2000 up to November 2019.

Outcomes

The primary outcome was the impact of reduced working time with retained salary on health effects, interventional and observational studies providing a quantitative analysis of any health-related outcome were included. Studies with qualitative research methods were excluded.

Results

A total of 3876 published articles were identified and 7 studies were selected for the final analysis, all with a longitudinal interventional design. The sample size ranged from 63 participants to 580 workers, mostly from healthcare settings. Two studies assessed a work-time reduction to 6 hours per day; two studies evaluated a weekly work-time reduction of 25%; two studies evaluated simultaneously a reduced weekly work-time reduction proportionally to the amount of time worked and a 2.5 hours of physical activity programme per week instead of work time; one study assessed a reduced weekly work-time reduction from 39 to 30 hours per week. A positive relationship between reduced working hours and working life quality, sleep and stress was observed. It is unclear whether work time reduction determined an improvement in general health outcomes, such as self-perceived health and well-being.

Conclusions

These findings suggest that the reduction of working hours with retained salary could be an effective workplace intervention for the improvement of employees’ well-being, especially regarding stress and sleep. Further studies in different contexts are needed to better evaluate the impact of work-time reduction on other health outcomes.
Effectiveness and cost-effectiveness of surgery versus casting for elderly patients withDisplaced intra-Articular type C distalRadius fractures: protocol of a randomised controlledTrial with economic evaluation (the DART study)
Authors: ter Meulen D P , Mulders M A M , Kruiswijk A A , Kret E J , Slichter M E , van Dongen J M , Kerkhoffs G M M J , Goslings J C , Kleinlugtenbelt Y V , Willigenburg N W , Schep N W L , Poolman R W
Published: April 2022

Introduction

Current literature is inconclusive about the optimal treatment of elderly patients with displaced intra-articular distal radius fractures. Cast treatment is less invasive and less expensive than surgical treatment. Nevertheless, surgery is often the preferred treatment for this common type of distal radius fracture. Patients with a non-acceptable position after closed reduction are more likely to benefit from surgery than patients with an acceptable position after closed reduction. Therefore, this study aims to assess non-inferiority of functional outcomes after casting versus surgery in elderly patients with a non-acceptable position following a distal radius fracture.

Methods and analysis

This study is a multicentre randomised controlled trial (RCT) with a non-inferiority design and an economic evaluation alongside. The population consists of patients aged 65 years and older with a displaced intra-articular distal radius fracture with non-acceptable radiological characteristics following either inadequate reduction or redisplacement after adequate reduction. Patients will be randomised between surgical treatment (open reduction and internal fixation) and non-operative treatment (closed reduction followed by cast treatment). We will use two age strata (65–75 and >75 years of age) and a web-based mixed block randomisation. A total of 154 patients will be enrolled and evaluated with the patient-rated wrist evaluation as the primary outcome at 1-year follow-up. Secondary outcomes include the Disabilities of the Arm, Shoulder and Hand questionnaire, quality of life (measured by the EQ-5D), wrist range of motion, grip strength and adverse events. In addition, we will perform a cost-effectiveness and cost-utility analysis from a societal and healthcare perspective. Incremental cost-effectiveness ratios, cost-effectiveness planes and cost-effectiveness acceptability curves will be presented.

Ethics and dissemination

The Research and Ethics Committee approved this RCT (NL56858.100.16). The results of this study will be reported in a peer-reviewed journal. We will present the results of this study at (inter)national conferences and disseminate the results through guideline committees.

Trial registration number

Clinicaltrials.gov (NCT03009890). Dutch Trial Registry (NTR6365).
Role of religious beliefs on antiretroviral treatment adherence among Pentecostal Christians in sub-Saharan Africa: a scoping review protocol
Authors: Azia Ivo , Mukumbang Ferdinand C , Shernaaz Carelse , Nyembezi Anam
Published: April 2022

Introduction

Sub-Saharan Africa continues to be disproportionately affected by HIV/AIDS. As such, several countries in sub-Saharan Africa are implementing the UNAIDS’ recommendation to test and treat people living with HIV (PLHIV) irrespective of their CD4 count. However, most of the antiretroviral treatment (ART) programmes, in this region, continue to struggle with poor adherence to treatment stemming from patient-related factors including their religious beliefs. Unfortunately, the role of religious beliefs on ART adherence has been underexplored in the literature. In this study protocol, we propose the steps of a scoping review to explore, identify and map the literature on the impact of religious beliefs on adherence to ART among Pentecostals living with HIV in sub-Saharan Africa.

Methods and analysis

We will use Arksey and O’Malley’s framework and the Joanna Briggs Institute methodology guidelines to conduct this scoping review. The following databases will be searched for relevant literature: Web of Science, PubMed/Medline, Psych-ARTICLES, Academic Search Complete, Cumulative Index of Nursing, Allied Health, Google Scholar and published articles from conference proceedings. Studies published between January 2010 and February 2022 will be eligible. The identified literature will be independently screened for eligibility by two reviewers based on predetermined inclusion and exclusion criteria. An Excel form will be designed to electronically capture data from studies that meet the inclusion criteria. Finally, we will use a narrative synthesis to summarise the data extracted to report on the nature of existing evidence and the impact of religious beliefs on ART adherence.

Ethics and dissemination

Ethical approval will not be required for the scoping review since it will entail synthesising information from already published articles and conference proceedings. The study findings will be disseminated through publication in a scientific journal and presented at conferences and workshops aimed at improving adherence to ART in PLHIV.
Patient and provider’s perspective on barriers and facilitators for medication adherence among adult patients with cardiovascular diseases and diabetes mellitus in India: a qualitative evidence synthesis
Authors: Krishnamoorthy Yuvaraj , Rajaa Sathish , Rehman Tanveer , Thulasingam Mahalakshmi
Published: April 2022

Objective

To explore the various stakeholders’ perspectives on barriers and facilitators for medication adherence among patients with cardiovascular diseases (CVDs) and diabetes mellitus (DM)in India.

Design

Systematic review of qualitative studies.

Data sources

A comprehensive systematic search was conducted in Medline, Cochrane Library, Science Direct and Google Scholar from January 2010 to July 2020. We included all qualitative peer-reviewed studies, reporting barriers and facilitators of medication adherence, from India, for our current review.

Data extraction and synthesis

Data extraction was performed by two independent authors who also assessed the quality of included studies using the Critical Appraisal Skills Programme criteria. This qualitative evidence synthesis adhered to the enhancing transparency in reporting the synthesis of qualitative research checklist

Results

In total, 18 studies were included. Major barriers reported were lack of understanding about the disease, complications related to non-adherence, followed by forgetfulness, lack of family support and risk communication. Health system-related barriers such as accessibility, affordability and acceptability were also reported by majority of the studies. Creation of peer support groups, digital reminder systems, integration of native Indian systems of India, physiotherapy and geriatric clinics at the primary healthcare level and innovations in patient care were suggested to counter these barriers in medication adherence.

Conclusion

Such patient-specific targeted interventions need to be developed to achieve better control among patients with CVD and DM.

PROSPERO registration number

CRD42020199529.
Association of self-reported snoring and hyperuricaemia: a large cross-sectional study in Chongqing, China
Authors: Chen Ting , Ding Xianbin , Tang Wenge , Chen Liling , Mao Deqiang , Song Lingling , Lian Xuemei
Published: April 2022

Objective

To examine the relationship between self-reported snoring and hyperuricaemia in a large-scale population in Chongqing, China.

Setting

Face-to-face electronic questionnaire survey, physical examination and biological sample testing were conducted in 13 districts of Chongqing. Chongqing is a municipality in southwest China.

Participants

In this study, 23 308 Han ethnicity permanent residents aged 30–79 years were recruited. Individuals missing data were excluded, 22 389 subjects were included in final analysis.

Primary and secondary outcome measures

Serum uric acid (UA) was measured using an oxidase method. Hyperuricaemia was defined as serum UA >420 µmol/L in men and >360 µmol/L in women. Information about self-reported snoring was obtained by questionnaire survey. All participants were divided into ‘no snoring’ ‘snoring occasionally’ and ‘snoring frequently’. Multivariable logistic regression analysis was performed to assess the relationship between self-reported snoring and hyperuricaemia.

Results

The prevalence of hyperuricaemia was 14.43%, and snorers were more likely to have hyperuricaemia than non-snorer in different age and gender groups. For the total population, those who snore occasionally or frequently were more likely to be hyperuricaemia (OR 1.19, 95% CI 1.07 to 1.31; OR 1.33, 95% CI 1.19 to 1.47) compared with no snoring people. Stratification by age, gender and body mass index (BMI), we found that the positive association between snoring frequently and hyperuricaemia was insisted in different age, gender and high BMI groups, and the strength of association varied with different age, gender and BMI category.

Conclusion

Snoring frequency was positively associated with higher risk of hyperuricaemia. Snoring frequently may be a signal for hyperuricaemia, especially for women, those over 59 years of age, or those who are overweight or obese.
Learning from alcohol (policy) reforms in the Northern Territory (LEARNT): protocol for a mixed-methods study examining the impacts of the banned drinker register
Authors: Miller Peter , Coomber Kerri , Smith James , Livingston Michael , Stevens Matthew , Guthridge Steven , Room Robin , Wright Cassandra J C , Rung Daile , Clifford Sarah , Baldwin Ryan , Das Sumon , Paradies Yin , Scott Debbie , Griffiths Kalinda E , Farmer Clare , Mayshak Richelle , Silver Bronwyn , Moore Sam , Mack Jordan , Mithen Vincent , Dyall Danielle , Ward J , Boffa John , Chikritzhs Tanya
Published: April 2022

Introduction

The Banned Drinker Register (BDR) was reintroduced in the Northern Territory (NT) in September 2017. The BDR is a supply reduction measure and involves placing people who consume alcohol at harmful levels on a register prohibiting the purchase, possession and consumption of alcohol. The current study aims to evaluate the impacts of the reintroduction of the BDR, in the context of other major alcohol policy initiatives introduced across the NT such as Police Auxiliary Liquor Inspectors and a minimum unit price for alcohol of US$1.30 per standard drink.

Methods and analyses

The Learning from Alcohol (policy) Reforms in the Northern Territory project will use a mixed-methods approach and contain four major components: epidemiological analysis of trends over time (outcomes include health, justice and social welfare data); individual-level data linkage including those on the BDR (outcomes include health and justice data); qualitative interviews with key stakeholders in the NT (n≥50); and qualitative interviews among people who are, or were previously, on the BDR, as well as the families and communities connected to those on the BDR (n=150). The impacts of the BDR on epidemiological data will be examined using time series analysis. Linked data will use generalised mixed models to analyse the relationship between outcomes and exposures, utilising appropriate distributions. Qualitative data will be analysed using thematic analysis.

Ethics and dissemination

Ethics approvals have been obtained from NT Department of Health and Menzies School of Health Research Human Research Ethics Committee (HREC), Central Australia HREC and Deakin University HREC. In addition to peer-reviewed publications, we will report our findings to key organisational, policy, government and community stakeholders via conferences, briefings and lay summaries.