bluuebunny/crossref_metadata_2025 huggingface dataset:
Sex differences in soluble prorenin receptor in patients with type 2 diabetes
Authors: Visniauskas Bruna , Arita Danielle Y. , Rosales Carla B. , Feroz Mohammed A. , Luffman Christina , Accavitti Michael J. , Dawkins Gabrielle , Hong Jennifer , Curnow Andrew C. , Thethi Tina K. , Lefante John J. , Jaimes Edgar A. , Mauvais-Jarvis Franck , Fonseca Vivian A. , Prieto Minolfa C.
Published: May 2021

Background

The soluble prorenin receptor (sPRR), a member of the renin-angiotensin system (RAS), is elevated in plasma of patients with preeclampsia, hypertension, chronic kidney disease (CKD), and type 2 diabetes. Our goal was to examine the relationship between sPRR and RAS activation to define whether sexual dimorphisms in sPRR might explain sex disparities in renal outcomes in patients with type 2 diabetes.

Methods

Two hundred sixty-nine participants were included in the study (mean age, 48 ± 16 years; 42% men, 58% women), including 173 controls and 96 subjects with type 2 diabetes. In plasma and urine, we measured sPRR, plasma renin activity (PRA), and prorenin. In the urine, we also measured angiotensinogen along with other biomarkers of renal dysfunction.

Results

Plasma sPRR and PRA were significantly higher in women with type 2 diabetes compared to men. In these women, plasma sPRR was positively correlated with PRA, age, and body mass index (BMI). In contrast, in men the sPRR in urine but not in plasma positively correlated with eGFR in urine, but negatively correlated with urine renin activity, plasma glucose, age, and BMI.

Conclusions

In patients with type 2 diabetes, sPRR contributes to RAS stimulation in a sex-dependent fashion. In diabetic women, increased plasma sPRR parallels the activation of systemic RAS; while in diabetic men, decreased sPRR in urine matches intrarenal RAS stimulation. sPRR might be a potential indicator of intrarenal RAS activation and renal dysfunction in men and women with type 2 diabetes.
Sex differences associated with adverse drug reactions resulting in hospital admissions
Authors: Hendriksen L. C. , van der Linden P. D. , Lagro-Janssen A. L. M. , van den Bemt P. M. L. A. , Siiskonen S. J. , Teichert M. , Kuiper J. G. , Herings R. M. C. , Stricker B. H. , Visser L. E.
Published: May 2021

Background

Adverse drug events, including adverse drug reactions (ADRs), are responsible for approximately 5% of unplanned hospital admissions: a major health concern. Women are 1.5–1.7 times more likely to develop ADRs. The main objective was to identify sex differences in the types and number of ADRs leading to hospital admission.

Methods

ADR-related hospital admissions between 2005 and 2017 were identified from the PHARMO Database Network using hospital discharge diagnoses. Patients aged ≥ 16 years with a drug possibly responsible for the ADR and dispensed within 3 months before admission were included. Age-adjusted odds ratios (OR) with 95% CIs for drug-ADR combinations for women versus men were calculated.

Results

A total of 18,469 ADR-related hospital admissions involving women (0.35% of all women admitted) and 14,678 admissions involving men (0.35% of all men admitted) were included. Most substantial differences were seen in ADRs due to anticoagulants and diuretics. Anticoagulants showed a lower risk of admission with persistent haematuria (ORadj 0.31; 95%CI 0.21, 0.45) haemoptysis (ORadj 0.47, 95%CI 0.30,0.74) and subdural haemorrhage (ORadj 0.61; 95%CI 0.42,0.88) in women than in men and a higher risk of rectal bleeding in women (ORadj 1.48; 95%CI 1.04,2.11). Also, there was a higher risk of admission in women using thiazide diuretics causing hypokalaemia (ORadj 3.03; 95%CI 1.58, 5.79) and hyponatraemia (ORadj 3.33, 95%CI 2.31, 4.81) than in men.

Conclusions

There are sex-related differences in the risk of hospital admission in specific drug-ADR combinations. The most substantial differences were due to anticoagulants and diuretics.
Dynamics in a ratio-dependent Lotka–Volterra competitive-competitive-cooperative system with feedback controls and delays
Authors: Muhammadhaji Ahmadjan , Halik Azhar , Li Hong-Li
Published: May 2021

This study investigates the dynamical behavior of a ratio-dependent Lotka–Volterra competitive-competitive-cooperative system with feedback controls and delays. Compared with previous studies, both ratio-dependent functional responses and time delays are considered. By employing the comparison method, the Lyapunov function method, and useful inequality techniques, some sufficient conditions on the permanence, periodic solution, and global attractivity for the considered system are derived. Finally, a numerical example is also presented to validate the practicability and feasibility of our proposed results.
Preliminary development of a bystander intervention scale for depression and the examination of socio-demographic correlates amongst Singapore university students
Authors: Ong Wei Jie , Lau Jue Hua , Abdin Edimansyah , Shahwan Shazana , Goh Janrius Chong Min , Tan Gregory Tee Hng , Samari Ellaisha , Kwok Kian Woon , Subramaniam Mythily , Chong Siow Ann
Published: April 2021

Background

Despite peer involvement having a positive impact on help-seeking behavior, there is a lack of a scale quantifying the possibility of an individual intervening upon noticing peers who show signs of depression. The aims of this study were to (1) develop a bystander intervention scale for depression that assesses the likelihood of university students intervening when a peer shows signs of depression based on the theory of bystander intervention, (2) identify the underlying factors contributing to the behavior, and (3) explore the socio-demographic correlates of the scale.

Methods

The proposed scale, the Bystander Intervention Scale for Depression (BISD), is a 17-item self-reported questionnaire that was developed based on existing bystander intervention theory and inputs from mental health experts. Data was collected as part of a larger study to evaluate the effectiveness of an anti-stigma intervention amongst university students from a local university. A total of 392 participants were recruited. Exploratory factor analyses were performed to identify the underlying factor structure. Multiple linear regressions were conducted to explore the socio-demographic correlates of the scale.

Result

Four key factors were identified for the proposed scale: (1) Awareness of depression among peers; (2) Vigilance towards possible symptoms of depression; (3) Knowledge on how to intervene; (4) Acceptance of responsibility to intervene. Having experience in the mental health field was associated with all factors while having family members or friends with mental illness was associated with all factors except for knowledge on how to intervene. Students of older age were associated with higher vigilance towards possible symptoms of depression and knowledge on how to intervene. Those of non-Chinese ethnicity were associated with acceptance of responsibility to intervene.

Conclusion

This study provides a preliminary tool to assess bystander intervention in depression amongst university students. This study identifies sub-groups of the student population that require more education to intervene with depressed peers and also informs the development of future strategies.
Robust α-synuclein pathology in select brainstem neuronal populations is a potential instigator of multiple system atrophy
Authors: Hass Ethan W. , Sorrentino Zachary A. , Lloyd Grace M. , McFarland Nikolaus R. , Prokop Stefan , Giasson Benoit I.
Published: May 2021

Multiple system atrophy (MSA) is an insidious middle age-onset neurodegenerative disease that clinically presents with variable degrees of parkinsonism and cerebellar ataxia. The pathological hallmark of MSA is the progressive accumulation of glial cytoplasmic inclusions (GCIs) in oligodendrocytes that are comprised of α-synuclein (αSyn) aberrantly polymerized into fibrils. Experimentally, MSA brain samples display a high level of seeding activity to induce further αSyn aggregation by a prion-like conformational mechanism. Paradoxically, αSyn is predominantly a neuronal brain protein, with only marginal levels expressed in normal or diseased oligodendrocytes, and αSyn inclusions in other neurodegenerative diseases, including Parkinson’s disease and Dementia with Lewy bodies, are primarily found in neurons. Although GCIs are the hallmark of MSA, using a series of new monoclonal antibodies targeting the carboxy-terminal region of αSyn, we demonstrate that neuronal αSyn pathology in MSA patient brains is remarkably abundant in the pontine nuclei and medullary inferior olivary nucleus. This neuronal αSyn pathology has distinct histological properties compared to GCIs, which allows it to remain concealed to many routine detection methods associated with altered biochemical properties of the carboxy-terminal domain of αSyn. We propose that these previously underappreciated sources of aberrant αSyn could serve as a pool of αSyn prion seeds that can initiate and continue to drive the pathogenesis of MSA.
Spatiotemporal distribution of potentially toxic elements in the lower Gangetic delta and their implications for non-carcinogenic health risk management
Authors: Ghosh Somdeep , Bakshi Madhurima , Mahanty Shouvik , Gaine Tanushree , Bhattacharyya Subarna , Biswas Jayanta Kumar , Chaudhuri Punarbasu
Published: May 2021

River Hooghly, a tributary of river Ganges is one of the major rivers of Asia having traditional, social, economic, religious, and spiritual values. Water samples were collected from 18 sampling locations of river Hooghly during summer (dry), monsoon (wet), and winter (cold) seasons. The samples are analysed for basic physicochemical properties and abundance of selected potentially toxic elements (PTEs) are measured. Several PTEs, e.g., Al, Fe, Ni, and Pb, were found to be above the permissible limits, prescribed by national and international guidelines for safe human consumption. The trend of variation in the mean PTE concentrations showed the following order: Cd < Pb < Co < Cr < Ni < Cu < Zn < Mn < Fe. Due to the presence of high total dissolve solid (TDS) and PTE contents, the water quality of river Hooghly is not suitable for direct human consumption. The evaluated Water Quality Index (WQI) value showed a distinct spatio-temporal variation indicating very severe condition of water quality, which is deteriorating gradually from upstream to downstream. In summer, monsoon, and winter, the highest WQI values were observed in Maushuni Island (S15), Petuaghat (S18), and Tapoban (S17), respectively. However, the non-carcinogenic human health risk in terms of Hazard Quotient and Hazard Index values of PTEs indicates no immediate adverse impact on human health due to exposure of PTE contaminated water from river Hooghly through ingestion or dermal route. Though, these risk values for children were higher than adults warranting the adoption of a long-term management plan to cope with potential human health risks. The result suggests implementation of a combination of stringent socio-legal regulations and numerical models for sustainable water related health risk management in river Hooghly.
Enhanced student perceptions of learning and performance using concept-point-recovery teaching sessions: a mixed-method approach
Authors: Cho Hyun Jin , Melloch Michael R. , Levesque-Bristol Chantal
Published: May 2021

Background

Active learning pedagogy has recently received a great deal of attention, and many universities have attempted to create student-centered learning environments to improve students’ academic success. The purpose of this study is to explore the impact of concept-point-recovery (CPR) teaching sessions as an active learning strategy on students’ perceptions of the learning environment, motivation, and academic learning outcomes in an electrical engineering course. To investigate the effectiveness of CPR sessions, students’ perceptions of learning and their performance were compared to those of students in a control classroom. Finally, students’ written comments on the course and instructor were explored in further analysis.

Results

The quantitative findings revealed that there was a significant change in students’ perceptions of learning after the CPR teaching sessions, and there was an increase in students’ perceptions and learning outcomes compared with those of the control group. In addition, the qualitative findings from students’ written feedback demonstrated that students felt that the instructor cared about students’ learning and success and that they had a positive learning environment.

Conclusions

CPR teaching sessions can be an alternative model for instructors to connect with students and create supportive environments to help students achieve academic success, which in turn promotes the satisfaction of students’ basic psychological needs and self-determined motivation. Therefore, increasing students’ engagement in their learning processes and making connections with students through CPR teaching sessions can facilitate improvements in students’ motivation and academic success. How this new active learning technique can be applied to higher education is discussed.
Effect of number of medications and use of potentially inappropriate medications on frailty among early-stage older outpatients
Authors: Uragami Yuya , Takikawa Kazuhiro , Kareki Hajime , Kimura Koji , Yamamoto Kazuyuki , Iihara Naomi
Published: May 2021

Background

Frailty is an urgent concern among an aging population worldwide. However, the relationship between frailty and number and types of medications has not been studied in detail among early-stage older patients, and it is unclear what prescriptions may have a role in preventing frailty. This study aimed to clarify the effects of number of medications and use of potentially inappropriate medications (PIMs) on frailty among early-stage older outpatients in Japan.

Methods

A cross-sectional study was undertaken. Frailty scores and medications of outpatients aged 65–74 years who regularly visited community pharmacies were investigated. Frailty scores were classified as 0 (non-frailty), 1–2 (pre-frailty), and ≥ 3 (frailty). The association between frailty and number of medications was analyzed by age and compared between PIM use and non-use groups. The proportion of patients who used PIMs was also analyzed by frailty score.

Results

Of 923 older outpatients, 49 (5.3%) and 318 (34.5%) patients had frailty and pre-frailty scores, respectively. The numbers of medications among patients with pre-frailty and frailty were significantly higher than among those with non-frailty (p <  0.001 for both). A similar increase was shown for PIM use groups aged 69–71 and 72–74 years, but not for the PIM use group aged 65–68 years and all groups without PIM use. An increasing linear trend was observed for the relationship between the proportion of patients who used any PIM, as well as some subcategories of PIMs (such as NSAIDs, benzodiazepines, loop diuretics and antithrombotic drugs) and frailty score.

Conclusions

Unnecessary medication use among early-stage older outpatients, especially patients aged ≥69 years who use PIMs and many medications, seems to be associated with frailty, but further research is needed to confirm these findings.
Surgical resection of extremely rare primary giant splenic angiomyolipoma: a case report
Authors: Sato Kaoru , Saijo Fumito , Katayose Yu , Mutoh Mitsuhisa , Iwama Noriyuki , Nakayama Fumie , Tokumura Hiromi
Published: May 2021

Background

Angiomyolipoma is a benign mesenchymal tumor that develops commonly in the kidney and rarely in other organs. The involvement of the spleen in angiomyolipoma is extremely rare, and only one such case has been reported in the English literature.

Case presentation

A 27-year-old man presented with adenoid hyperplasia and bilateral palatal tonsillar hyperplasia. During the treatment for adenoid hyperplasia, a 15-cm tumor was detected in the spleen using abdominal ultrasonography and enhanced computed tomography. Partial resection of the spleen was successfully performed. A giant tumor of approximately 13 cm with a smooth surface was observed in the upper left quadrant of the abdomen. The tumor was confirmed to be continuous with the upper spleen, and there was no invasion of the other organs. The postoperative course was good, and the patient was discharged on the 7th postoperative day. The excised specimen was a smooth, extremely soft tumor measuring 123 × 120 × 82 mm. The cleaved surface of the tumor was reddish brown, and a distressing yellow color was observed. Pathological examination revealed a proliferation of mature adipocytes and an increase in the number of blood vessels of various sizes. Furthermore, spindle-shaped cell proliferation foci were visible between the adipocytes and the surrounding blood vessels. Profuse leakage of erythrocytes from the blood vessels, hemosiderin deposition, and small round cell infiltration were also noted. Immunostaining disclosed that the spindle-shaped cells were weakly positive for smooth muscle antibody and were identified as smooth muscle cells. The adipocytes and spindle cells were negative for HMB 45, Melan A, MDM, and CDK4. However, some parts of the cells were positive for estrogen and progesterone receptors. Besides, vascular endothelial cells were positive for CD31 and CD34 and negative for CD8. Based on these findings, the patient was diagnosed to have primary angiomyolipoma of the spleen.

Conclusions

We have reported the surgical treatment for an extremely rare case of giant splenic angiomyolipoma in a young man. Globally, this is the second report on this condition. We believe that partial splenic resection is a feasible option for the management of giant tumors.
A high-dimensionality-trait-driven learning paradigm for high dimensional credit classification
Authors: Yu Lean , Yu Lihang , Yu Kaitao
Published: April 2021

To solve the high-dimensionality issue and improve its accuracy in credit risk assessment, a high-dimensionality-trait-driven learning paradigm is proposed for feature extraction and classifier selection. The proposed paradigm consists of three main stages: categorization of high dimensional data, high-dimensionality-trait-driven feature extraction, and high-dimensionality-trait-driven classifier selection. In the first stage, according to the definition of high-dimensionality and the relationship between sample size and feature dimensions, the high-dimensionality traits of credit dataset are further categorized into two types: 100 < feature dimensions < sample size, and feature dimensions ≥ sample size. In the second stage, some typical feature extraction methods are tested regarding the two categories of high dimensionality. In the final stage, four types of classifiers are performed to evaluate credit risk considering different high-dimensionality traits. For the purpose of illustration and verification, credit classification experiments are performed on two publicly available credit risk datasets, and the results show that the proposed high-dimensionality-trait-driven learning paradigm for feature extraction and classifier selection is effective in handling high-dimensional credit classification issues and improving credit classification accuracy relative to the benchmark models listed in this study.
Involving elderly research participants in the co-design of a future multi-generational cohort study
Authors: Nunn Jack S. , Sulovski Merrin , Tiller Jane , Holloway Bruce , Ayton Darshini , Lacaze Paul
Published: May 2021

Background

It has been proposed that the existing ASPirin in Reducing Events in the Elderly Extension observational cohort study (ASPREE-XT) would provide a platform for a future multigenerational research study (MGRS). An advert was sent to 14,268 participants (aged 74 years and older, from Australia, and located in both metropolitan and rural locations) to invite them to share views and preferences about being involved in the co-design of a future MGRS, as their preferences were not known. The objective of this article is to report as a case study the process of involving study participants and how this impacted the co-design of a proposed multi-generational research study, using a novel standardised reporting tool.

Methods

We used participatory action research to involve elderly research participants in the co-design of a proposed multi-generational cohort study between 2017 and 2019 using newsletters, telephone interviews and an in-person workshop. We used the novel ‘Standardised Data on Initiatives Alpha Version 0.1’ (STARDIT 0.1) to plan and report how participant involvement activities positively impacted the study design.

Results

Fifty-nine ASPREE-XT participants were interviewed by telephone and 18 participants attended a face-to-face event. Involving participants positively impacted the proposed study design by improving the research objectives, developing protocols, influencing funding decisions and improving ethics applications. Learning points included the importance of maintaining the ideals of ASPREE-XT (respect, quality and transparency); research participants’ preference for the option of receiving results (including genetic results); participants’ need for involvement in decisions about recruitment, data access, governance and other ethical issues; and the preference for different communication methods, including both face-to-face and online methods. Data from the process indicated it was highly valued by all stakeholders, including research participants, study staff and lead investigators. Involvement of participants was described by a lead study investigator of ASPREE-XT as “enormously helpful”.

Conclusions

This case study demonstrates that including participants in the design of a research study positively impacted the study design, participants and researchers. Using a standardised reporting tool to describe the methods and impacts provides a way for learning from this case study to inform future research studies planning to involve people.
Effect of beneficiary participation in program design and implementation on satisfaction and acceptability among internally displaced persons in Borno, Nigeria
Authors: Ieren Igbaver Isaac , Kabuk-Agbadu Salome , Umeokonkwo Chukwuma
Published: May 2021

Insurgency and other security challenges have intensified across Nigeria with a resultant displacement of over a million people from over 100,000 households who depend on interventions from government and non-governmental organizations for survival since 2009. We conducted the study to determine the level of involvement of the displaced persons in planning, implementation and review of these interventions, and the effect of the participation on satisfaction with the interventions among camp dwellers in selected camps in Borno, Nigeria. A total of 278 internally displaced persons (IDPs) across 9 IDP camps were surveyed using an interviewer-administered questionnaire. Data was collected using Android-based Open Data Kit (ODK), exported into Microsoft Excel, and analyzed with SPSS version 21. Out of the 278 respondents, 143 (51.4%) were male, 82 (29.5%) respondents were within the age bracket of 26-35 years and above (mean age 38.9±12.3), over 78% were married, and 29.9% were involved in trading before their displacement. Among the respondents, 256 (92.1%) had benefitted from at least one intervention during their stay in the IDP camps. Over 96% of the beneficiaries were female, compared to 87.4% of males, which was statistically significant (p<0.05). All the respondents within the age group 26-35 years and above 45 years old who had received information about the interventions were satisfied, and this finding was statistically significant (p<0.05). Overall, 91.5% of respondents who had benefitted from previous interventions would like to be involved in all the intervention stages (planning, implementation, and review). In comparison, 100% of IDPs who benefitted from previous interventions would like to be involved in the implementation, and 96.8% of them would like to be involved in planning the proposed interventions. To ensure maximum coverage, and that optimum benefit is derived from development projects, beneficiaries should be involved in all stages of the project cycle.
Association of apolipoprotein B XbaI (rs693) polymorphism and gallstone disease risk based on a comprehensive analysis
Authors: Zhu Haifeng , Yu Linhai , Feng Linsong
Published: May 2021

Background

Our aim was to investigate the association between XbaI gene polymorphisms in the apolipoprotein B (APOB) gene and gallstone disease (GD) risk through a comparison of the allele and genotype distribution frequencies at this site using meta-analysis.

Methods

A literature search was performed using PubMed and Wanfang through Jun 1, 2020. Odds ratios (ORs) and 95 % confidence intervals (CIs) were used to assess the strength of associations.

Results

After a comprehensive search, 14 different articles that met the inclusion criteria were selected, with 1583 cases and 1794 controls. Individuals carrying the A-allele or AA genotype of the rs693 polymorphism were determined to possibly have an increased risk of GD. For example, there was a significant relationship between the rs693 polymorphism and increased GD risk in the whole group (OR: 1.40, 95 % CI: 1.05–1.87 in the allelic contrast model), the Asian population (OR: 1.58, 95 % CI: 1.48–2.84 in the heterozygote model), and the hospital-based source of the control (OR: 1.79, 95 % CI: 1.13–2.84 in the dominant model).

Conclusions

This study suggests that the APOB rs693 polymorphism is potentially associated with GD susceptibility, which might offer a detection marker for use in future large scale clinic research.
Learning analytics in higher education: a preponderance of analytics but very little learning?
Authors: Guzmán-Valenzuela Carolina , Gómez-González Carolina , Rojas-Murphy Tagle Andrés , Lorca-Vyhmeister Alejandro
Published: May 2021

In a context where learning mediated by technology has gained prominence in higher education, learning analytics has become a powerful tool to collect and analyse data with the aim of improving students’ learning. However, learning analytics is part of a young community and its developments deserve further exploration. Some critical stances claim that learning analytics tends to underplay the complexity of teaching-learning processes. By means of both a bibliometric and a content analysis, this paper examines the publication patterns on learning analytics in higher education and their main challenges. 385 papers that were published in WoScc and SciELO indexes between 2013 and 2019 were identified and analysed. Learning analytics is a vibrant and fast-developing community. However, it continues to face multiple and complex challenges, especially regarding students’ learning and their implications. The paper concludes by distinguishing between a practice-based and management-oriented community of learning analytics and an academic-oriented community. Within both communities, though, it seems that the focus is more on analytics than on learning.
Implementation support for contingency management: preferences of opioid treatment program leaders and staff
Authors: Scott Kelli , Jarman Shelly , Moul Samantha , Murphy Cara M. , Yap Kimberly , Garner Bryan R. , Becker Sara J.
Published: April 2021

Background

Contingency management (CM), a behavioral intervention that provides incentives for achieving treatment goals, is an evidence-based adjunct to medication to treat opioid use disorder. Unfortunately, many front-line treatment providers do not utilize CM, likely due to contextual barriers that limit effective training and ongoing support for evidence-based practices. This study applied user-informed approaches to adapt a multi-level implementation strategy called the Science to Service Laboratory (SSL) to support CM implementation.

Methods

Leaders and treatment providers working in community-based opioid treatment programs (OTPs; N = 43) completed qualitative interviews inquiring about their preferences for training and support implementation strategies (didactic training, performance feedback, and external facilitation). Our team coded interviews using a reflexive team approach to identify common a priori and emergent themes.

Results

Leaders and providers expressed a preference for brief training that included case examples and research data, along with experiential learning strategies. They reported a desire for performance feedback from internal supervisors, patients, and clinical experts. Providers and leaders had mixed feelings about audio-recording sessions but were open to the use of rating sheets to evaluate CM performance. Finally, participants desired both on-call and regularly scheduled external facilitation to support their continued use of CM.

Conclusions

This study provides an exemplar of a user-informed approach to adapt the SSL implementation support strategies for CM scale-up in community OTPs. Study findings highlight the need for user-informed approaches to training, performance feedback, and facilitation to support sustained CM use in this setting.
Diagnostic performance of lung volumes in assessment of reversibility in chronic obstructive pulmonary disease
Authors: Agmy Gamal , A. Mahmoud Manal , Ali Azza Bahaa El-Din , Adam Mohamed
Published: May 2021

Background

Reversibility measured by spirometry in chronic obstructive pulmonary disease (COPD) is defined as an increase in forced expiratory volume in first second (FEV1) that is both more than 12% and 200 mL above the pre-bronchodilator value in response to inhaled bronchodilators. FEV1 only may not fully reverberate the changes caused by reduction in air trapping or hyperinflation. To date, the studies that examined the effect of inhaled bronchodilators (BD) on residual volume (RV) and total lung capacity (TLC) are limited. This study was carried out to assess the differences between flow and volume responses after bronchodilator reversibility testing in patients with different COPD GOLD stages (GOLD stage I to stage IV). Spirometry and whole body plethysmography were done before and 15 min after inhalation of 400 μg salbutamol.

Results

Majority (53.3%) of cases were volume responders, 18.7% were flow responders, 20% were flow and volume responders, and 8% were non responders. Significant increase in Δ FEV1% was found in 15% of cases while 55% showed a significant increase in Δ FVC (P= < 0.001). Mean difference of Δ FVC (L) post BD was significantly increased with advancing GOLD stage (P= 0.03). A cutoff point > 20% forΔRV% had 70% sensitivity and 60% specificity and > 12% forΔTLC% showed 90% sensitivity and 45% specificity for prediction of clinically significant response to BD based on FEV1. A cutoff point > 18% forΔRV% had 78% sensitivity and 29% specificity and > 14% for Δ TLC% had 50% sensitivity and 70% specificity for prediction of clinically significant response to BD based on FVC.

Conclusion

ΔFEV1 underestimates the true effect of bronchodilators with advancing GOLD stage. Measurement of lung volumes in addition to the standard spirometric indices is recommended when determining bronchodilator response in COPD patients.
Low-frequency, long-offset elastic waveform inversion in the context of velocity model building
Authors: Plessix René-Édouard , Krupovnickas Tadas
Published: May 2021

Classic imaging approaches consist of splitting the earth into background and reflectivity models. When justified, this separation of scale is quite powerful, although this approach relies on some smoothness and weak contrast assumptions. This approach allows for the imaging methods to be based on acoustic wave propagation after having identified the compressional waves through picking or signal processing. Over the past years, wave-equation tomography and waveform inversion approaches have become routine, complementing the classic approaches to derive background models. They do not rely on high-frequency picks, unlike ray-based traveltime tomography, but on low-frequency cross-correlation to define time shifts and on waveform matching. In the presence of large earth parameter contrasts, time shifts and waveforms of compressional waves may depend on elastic parameters when interferences occur within the Fresnel zones. This challenges the recovery of the background model under an acoustic assumption with low-frequency data. Accounting for an elastic propagation in waveform inversion, even in the context of model building, could help to reduce the artifacts seen in acoustic results. A synthetic and a real data example are presented to illustrate the potential benefit of using an elastic waveform inversion approach when inverting long-offset, low-frequency seismic data.
Imaging ahead of and around the bit in a desert environment: DrillCAM field trial with wireless geophones and top-drive sensor
Authors: Aldawood Ali , Hemyari Emad , Silvestrov Ilya , Bakulin Andrey
Published: May 2021

Advanced seismic-while-drilling (SWD) technologies are being utilized to steer drilling operations and provide high-resolution subsurface images around and ahead of the bit. We present a case study of SWD imaging using a recently acquired field data set from a desert environment with a complex near surface. Data acquisition is performed with wireless geophones and top-drive sensors using continuous real-time recording. The drill-bit noise data are analyzed while continuously recording in real time by using a specialized workflow that combines elements of SWD and conventional vertical seismic profiling processing with controlled seismic sources. First, the workflow enhances the direct wavefield to retrieve accurate first-break picks for traveltime tomographic inversion along east–west- and north–south-striking walkaway lines. Then, it extracts and enhances upgoing reflection events, illuminating parts of the subsurface around and ahead of the bit. During the final step, these upgoing reflections are imaged using the inverted velocity model to reconstruct a migrated subsurface image around the well. As is the case for land surface seismic in the presence of a complex near surface, we observe a significant variation of data quality for the orthogonal receiver lines. As a result, each line provides a robust image of a different part of the subsurface. The east–west-striking line's migrated image delineates a major shallow reflector that serves as a marker for predicting the drilling depth of a deeper horizon. Likewise, migrating upgoing reflections from the north–south line accurately maps a deeper target horizon ahead of the bit. The obtained SWD images assist in setting the casing points accurately and provide a more precise ahead-of-the-bit depth for different horizons with significantly less uncertainty than surface seismic.
Spherical calibration and quality control of ground and UAV vector magnetometer data
Authors: Cunion Ed
Published: May 2021

Ground traverse and unmanned aerial vehicle (UAV) airborne magnetic mapping results covering an urban landfill are compared for a picoTesla-resolution fluxgate vector magnetometer (FVM). Rural and urban system noise tests are undertaken first to develop FVM quality assessment and control methods that are then used for processing the landfill survey data. The FVM ground and UAV survey results are subsequently compared with a femtoTesla-resolution alkali-vapor scalar magnetometer ground survey that provides a scalar total magnetic intensity image reference standard.
Referral patterns for specialist child and adolescent mental health services in the Republic of Ireland during the COVID-19 pandemic compared with 2019 and 2018
Authors: McNicholas Fiona , Kelleher Ian , Hedderman Elma , Lynch Fionnuala , Healy Elaine , Thornton Therese , Barry Edwina , Kelly Lisa , McDonald James , Holmes Keith , Kavanagh Glenda , Migone Maria
Published: May 2021

Background

Countries worldwide are experiencing a third wave of the coronavirus disease 2019 (COVID-19) pandemic. Government-imposed restrictive measures continue with undetermined effects on physical and mental health.

Aims

To compare child and adolescent mental health services (CAMHS) referrals over 11 months (January–November) in 2020, 2019 and 2018 and examine any impact the different phases of the COVID-19 restrictions might have on referral rates.

Method

Monthly CAMHS Health Service Executive data were examined, covering a catchment population of 260 560 or 12.7% of all youth (age group 0–18 years) in Ireland. The total number of urgent and routine referrals, appointments offered, rates of non-attendances and discharge outcome are presented.

Results

There was a significant drop in referrals in 2020, compared with prior years (χ2 = 10.3, d.f. = 2, P = 0.006). Referrals in 2020 dropped from March to May by 11% and from June to August by 10.3%. From September, both routine and urgent referrals increased by 50% compared with previous years (2018/2019), with the highest increase in November 2020 (180%). Clinic activity also increased from September, with double the number of out-patient appointments offered, compared with previous years (χ2 = 5171.72, d.f. = 3, P < 0.001) and lower (6.6%) rates of non-attendance (χ2 = 868.35, d.f. = 3, P < 0.001).

Conclusions

In 2020, following an initial decline, referrals to CAMHS increased consistently from September. Such unprecedented increase in referrals places further strain on services that are already underresourced and underfunded, with the likelihood of increased waiting lists post COVID-19. It is envisaged that once the pandemic is over, resources will be even more constrained, and CAMHS will be urgently in need of additional ring-fenced funding.
Association between epilepsy and psychiatric disorders in adults with intellectual disabilities: systematic review and meta-analysis
Authors: Akrout Brizard Basma , Limbu Bharati , Baeza-Velasco Carolina , Deb Shoumitro
Published: May 2021

Background

Psychiatric disorders, such as depression and anxiety, are commonly associated with epilepsy in the general population, but the relationship between psychiatric disorders and epilepsy among adults with intellectual disabilities is unclear.

Aims

To conduct a systematic review and meta-analysis to assess whether epilepsy is associated with an increased rate of psychiatric disorders in adults with intellectual disabilities.

Method

We included literature published between 1985 and 2020 from four databases, and hand-searched six relevant journals. We assessed risk of bias by using SIGN 50 and the Cochrane risk of bias tool. Several meta-analyses were carried out.

Results

We included 29 papers involving data on 9594 adults with intellectual disabilities, 3180 of whom had epilepsy and 6414 did not. Of the 11 controlled studies that compared the overall rate of psychiatric disorders between the epilepsy and non-epilepsy groups, seven did not show any significant inter-group difference. Meta-analysis was possible on pooled data from seven controlled studies, which did not show any significant inter-group difference in the overall rate of psychiatric disorders. The rates of psychotic disorders, depressive disorders and anxiety disorders were significantly higher in the non-epilepsy control groups compared with the epilepsy group, with effect sizes of 0.29, 0.47 and 0.58, respectively. Epilepsy-related factors did not show any definite association with psychiatric disorders.

Conclusions

It is difficult to pool data from such heterogeneous studies and draw any definitive conclusion because most studies lacked an appropriately matched control group, which will be required for future studies.
Appropriate Systemic Therapy Dosing for Obese Adult Patients With Cancer: ASCO Guideline Update
Authors: Griggs Jennifer J. , Bohlke Kari , Balaban Edward P. , Dignam James J. , Hall Evan T. , Harvey R. Donald , Hecht Diane P. , Klute Kelsey A. , Morrison Vicki A. , Pini T. May , Rosner Gary L. , Runowicz Carolyn D. , Shayne Michelle , Sparreboom Alex , Turner Sophia , Zarwan Corrine , Lyman Gary H.
Published: May 2021

PURPOSE

To provide recommendations for appropriate dosing of systemic antineoplastic agents in obese adults with cancer.

METHODS

A systematic review of the literature collected evidence regarding dosing of chemotherapy, immunotherapy, and targeted therapies in obese adults with cancer. PubMed and the Cochrane Library were searched for randomized controlled trials, meta-analyses, or cohort studies published from November 1, 2010, through March 27, 2020. ASCO convened an Expert Panel to review the evidence and formulate recommendations.

RESULTS

Sixty studies, primarily retrospective, were included in the review. Overall, the evidence supported previous findings that obese adult patients tolerate full, body-size–based dosing of chemotherapy as well as nonobese patients. Fewer studies have addressed the dosing of targeted therapies and immunotherapies in relation to safety and efficacy in obese patients.

RECOMMENDATIONS

The Panel continues to recommend that full, weight-based cytotoxic chemotherapy doses be used to treat obese adults with cancer. New to this version of the guideline, the Panel also recommends that full, approved doses of immunotherapy and targeted therapies be offered to obese adults with cancer. In the event of toxicity, the consensus of the Panel is that dose modifications of systemic antineoplastic therapies should be handled similarly for obese and nonobese patients. Important areas for future research include the impact of sarcopenia and other measures of body composition on optimal antineoplastic dosing, and more customized dosing based on pharmacokinetic or pharmacogenetic factors. Additional information is available at www.asco.org/supportive-care-guidelines .
GLP1 Receptor Agonists Reduce Fluid Intake in Primary Polydipsia
Authors: Winzeler Bettina Felicitas , Sailer Clara Odilia , Coynel David , Deborah Vogt , Davide Zanchi , Urwyler Sandrine , Refardt Julie , Christ-Crain Mirjam
Published: May 2021

Background Primary polydipsia, characterized by excessive fluid intake, carries the risk of water intoxication and hyponatremia, but treatment options are scarce. Glucagon-like peptide-1 (GLP-1) reduces appetite and food intake. In experimental models, they also play a role in thirst and drinking behavior in. The aim of this trial was to investigate whether GLP-1 receptor agonists reduce fluid intake in patients with primary polydipsia. Methods: In this randomized, double-blind, placebo-controlled, 3-week crossover-trial, 34 patients with primary polydipsia received weekly dulaglutide (Trulicity®) 1.5mg and placebo (0.9% sodium chloride). During the last treatment week, patients attended an 8-hour evaluation visit with free water access. The primary endpoint was total fluid intake during the evaluation visits. The treatment effect was estimated using a linear mixed-effects model. In a subset of 15 patients and matched controls, thirst perception and neuronal activity in response to beverage pictures were assessed by functional MRI. Results Median [IQR] total fluid intake was 2250ml [1600-2600] on dulaglutide versus 2400ml [1850-3400] on placebo. Patients on dulaglutide reduced fluid intake by 490ml [95%-CI -780, -199], p=0.002, corresponding to a relative reduction of 17%. 24-hour urinary output was reduced by -943ml [95%-CI -1473, -413]. Thirst perception in response to beverage pictures was higher in patients with primary polydipsia versus controls and lower on dulaglutide versus placebo, but functional neuronal activity was similar between groups and treatments. Conclusion: GLP-1 receptor agonists reduce fluid intake and thirst perception in patients with primary polydipsia and could therefore be a novel treatment option for these patients.
Clinical Correlation to E-cadherin and Granulation Patterns in Corticotroph Tumors
Authors: Lipe Kristin A , Fishbein Lauren Michelle , Kerr Janice M , Youssef Samy A , Lillehei Kevin O , Wierman Margaret E , Kleinschmidt-Demasters B K , Kiseljak-Vassiliades Katja
Published: May 2021

Corticotroph adenomas, either secretory or silent, are associated with significant disease persistence and/or recurrence. Surgical resection is the first line treatment; however, recurrence rates range from 30 to 60%. Although several clinical parameters (i.e. postoperative cortisol level, tumor invasion) have been reported to predict tumor recurrence, none have high diagnostic accuracy. Granulation pattern classifies corticotroph tumors as densely granulated (DG) or sparsely granulated (SG) types, with the latter usually larger and more aggressively behaving. E-cadherin, a calcium-dependent adhesion molecule strongly expressed in normal pituitary cells, plays a role in epithelial cell behavior, tissue development, and suppresses epithelial-mesenchymal transition. Since loss of E-cadherin expression in sparsely granulated somatotroph pituitary tumors correlates with a more aggressive disease course, we sought to examine correlation between E-cadherin expression and behavior in densely versus sparsely granulated corticotroph tumors. A retrospective chart review of adult patients with corticotroph adenomas, seen at our institution between January 2012 - 2020 yielded 62 patients: 18 (29%) male and 44 female (71%), with median age at diagnosis of 49 years (range 25-82). Inclusion criteria required sufficient tissue for E- cadherin immunostaining (IHC). Microadenomas were identified in 19/62 (31%) patients, and 38/62 (52%) patients had clinical and biochemical findings consistent with excess cortisol secretion. Pre-operative imaging showed that 22/62 (35%) tumors were invasive into surrounding structures. After further classification as to densely granulated (DG) or sparsely granulated (SG) types by ACTH granulation pattern on IHC, 19/56 (34%) adenomas were SG, 37/56 (66%) were DG and 6 were not classified. E-cadherin staining was absent in 7/62 tumors (11%) and diminished in 5/62 (8%) tumors and staining did not correlate with dense versus sparse corticotroph types. Chi-squared analysis found a significant association between tumor size (greater than or less than 1cm) and secretion, with hormonally active more likely tumors to be microadenomas (p=0.004). Microadenomas were exclusively DG tumors (p<0.001). Further analysis did not find correlation between presence or absence of E-cadherin expression and tumor invasion into adjacent structures, or recurrence. In summary, the data suggests that, unlike somatotroph corticotroph adenomas for recurrence or invasion, nor does it correlate strongly with granulation status.