bluuebunny/crossref_metadata_2025 huggingface dataset:
Communication of palliative care needs in discharge letters from hospice providers to primary care: a multisite sequential explanatory mixed methods study
Authors: Weetman Katharine , Dale Jeremy , Mitchell Sarah J. , Ferguson Claire , Finucane Anne M. , Buckle Peter , Arnold Elizabeth , Clarke Gemma , Karakitsiou Despoina-Elvira , McConnell Tracey , Sanyal Nikhil , Schuberth Anna , Tindle Georgia , Perry Rachel , Grewal Bhajneek , Patynowska Katarzyna A. , MacArtney John I.
Published: September 2022

Background

The provision of palliative care is increasing, with many people dying in community-based settings. It is essential that communication is effective if and when patients transition from hospice to community palliative care. Past research has indicated that communication issues are prevalent during hospital discharges, but little is known about hospice discharges.

Methods

An explanatory sequential mixed methods study consisting of a retrospective review of hospice discharge letters, followed by hospice focus groups, to explore patterns in communication of palliative care needs of discharged patients and describe why these patients were being discharged. Discharge letters were extracted for key content information using a standardised form. Letters were then examined for language patterns using a linguistic methodology termed corpus linguistics. Thematic analysis was used to analyse the focus group transcripts. Findings were triangulated to develop an explanatory understanding of discharge communication from hospice care.

Results

We sampled 250 discharge letters from five UK hospices whereby patients had been discharged to primary care. Twenty-five staff took part in focus groups. The main reasons for discharge extracted from the letters were symptoms “managed/resolved” (75.2%), and/or the “patient wishes to die/for care at home” (37.2%). Most patients had some form of physical needs documented on the letters (98.4%) but spiritual needs were rarely documented (2.4%). Psychological/emotional needs and social needs were documented in 46.4 and 35.6% of letters respectively. There was sometimes ambiguity in “who” will be following up “what” in the discharge letters, and whether described patients’ needs were resolved or ongoing for managing in the community setting. The extent to which patients received a copy of their discharge letter varied. Focus groups conveyed a lack of consensus on what constitutes “complexity” and “complex pain”.

Conclusions

The content and structure of discharge letters varied between hospices, although generally focused on physical needs. Our study provides insights into patterns associated with those discharged from hospice, and how policy and guidance in this area may be improved, such as greater consistency of sharing letters with patients. A patient-centred set of hospice-specific discharge letter principles could help improve future practice.
Utilisation of modern contraceptives by sexually active adolescent girls in Rwanda: a nationwide cross-sectional study
Authors: Kawuki Joseph , Gatasi Ghislaine , Sserwanja Quraish , Mukunya David , Musaba Milton W.
Published: September 2022

Background

Modern contraceptive use has been shown to influence population growth, protect women’s health and rights, as well as prevent sexually transmitted infections (STIs) for barrier contraceptive methods such as condoms. The present study aimed at assessing the level of utilization and factors associated with modern contraceptive use among sexually active adolescent girls in Rwanda.

Methods

We used secondary data from the Rwanda Demographic and Health Survey (RDHS) 2020 data of 539 sexually active adolescent girls (aged 15 to 19 years). Multistage stratified sampling was used to select study participants. We conducted multivariable logistic regression to assess the association between various socio-demographics and modern contraceptive use using SPSS version 25. Modern contraception included the use of products or medical procedures that interfere with reproduction from acts of sexual intercourse.

Results

Of the 539 sexually active girls, only 94 (17.4%, 95% CI: 13.8–20.1) were using modern contraceptives. Implants (69.1%) and male condoms (12.8%) were the most used options. Modern contraceptive use was positively associated with older age (AOR = 10.28, 95% CI: 1.34–78.70), higher educational level (AOR = 6.98, 95% CI: 1.08–45.07), history of having a sexually transmitted infection (AOR = 8.27, 95% CI: 2.54–26.99), working status (AOR = 1.72, 95% CI: 1.03–2.88) and being from a female-headed household (AOR = 1.96, 95% CI: 1.12–3.43). However, not being in a union (AOR = 0.18, 95% CI: 0.10–0.35) and region (AOR = 0.28, 95% CI: 0.10–0.80) had negative associations.

Conclusions

To promote utilisation of modern contraceptives, family planning campaigns need to place more emphasis on the younger, unmarried adolescents, as well as those with lower educational levels. Consideration of household and regional dynamics is also highlighted.
Retraction Note: Xia-yu-xue decoction (XYXD) reduces carbon tetrachloride (CCl4)-induced liver fibrosis through inhibition hepatic stellate cell activation by targeting NF-κB and TGF-β1 signaling pathways
Authors: Liu Cheng , Yuan Xia , Tao Le , Cheng Zhuoan , Dai Xiuqin , Sheng Xia , Xue Dongying
Published: September 2022

This article has been retracted. Please see the Retraction Notice for more detail: 10.1186/s12906-015-0733-1
Cost-effectiveness analysis of mesh fixation techniques for laparoscopic and open inguinal hernia surgeries
Authors: Techapongsatorn Suphakarn , Tansawet Amarit , Pattanaprateep Oraluck , Attia John , Mckay Gareth J. , Thakkinstian Ammarin
Published: September 2022

Purpose

This study reports economic evaluation of mesh fixation in open and laparoscopic hernia repair from a prospective real-world cohort study, using cost-effectiveness analysis (CEA) and cost-utility analysis (CUA).

Methods

A prospective real-world cohort study was conducted in two university-based hospitals in Thailand from November 2018 to 2019. Patient data on hernia features, operative approaches, clinical outcomes, associated cost data, and quality of life were collected. Models were used to determine each group’s treatment effect, potential outcome means, and average treatment effects. An incremental cost-effectiveness ratio was used to evaluate the incremental risk of hernia recurrences.

Results

The 261 patients in this study were divided into six groups: laparoscopic with tack (LT, n = 47), glue (LG, n = 26), and self-gripping mesh (LSG, n = 30), and open with suture (OS, n = 117), glue (OG, n = 18), and self-gripping mesh (OSG, n = 23). Hernia recurrence was most common in LSG. The mean utility score was highest in OG and OSG (both 0.99). Treatment costs were generally higher for laparoscopic than open procedures. The cost-effectiveness plane for utility and hernia recurrence identified LSG as least cost effective. Cost-effectiveness acceptability curves identified OG as having the highest probability of being cost effective at willingness to pay levels between $0 and $3,300, followed by OSG.

Conclusion

Given the similarity of hernia recurrence among all major procedures, the cost of surgery may impact the decision. According to our findings, open hernia repair with adhesive or self-gripping mesh appears most cost-effective.
Impact of semaglutide on high-sensitivity C-reactive protein: exploratory patient-level analyses of SUSTAIN and PIONEER randomized clinical trials
Authors: Mosenzon Ofri , Capehorn Matthew S. , De Remigis Alessandra , Rasmussen Søren , Weimers Petra , Rosenstock Julio
Published: September 2022

Background

Exploratory analysis to determine the effect of semaglutide versus comparators on high-sensitivity C-reactive protein (hsCRP) in subjects with type 2 diabetes.

Methods

Trials of once-weekly subcutaneous (SUSTAIN 3) and once-daily oral (PIONEER 1, 2, 5) semaglutide with hsCRP data were analyzed. Subjects with type 2 diabetes (N = 2482) received semaglutide (n = 1328) or comparators (placebo, n = 339; exenatide extended-release, n = 405; empagliflozin, n = 410). hsCRP ratio to baseline at end-of-treatment was analyzed overall, by clinical cutoff (< 1.0, ≥ 1.0 to ≤ 3.0, or > 3.0 mg/L), by tertile, and by estimated glomerular filtration rate in PIONEER 5 (a trial which was conducted in a population with type 2 diabetes and chronic kidney disease [CKD]). Mediation analyses assessed the effect of change in glycated hemoglobin (HbA1c) and/or change in body weight (BW) on hsCRP reductions.

Results

Geometric mean baseline hsCRP was similar across trials (range 2.7–3.0 mg/L). Semaglutide reduced hsCRP levels by clinical cutoffs and tertiles from baseline to end-of-treatment in all trials versus comparators (estimated treatment ratios [ETRs] versus comparators: 0.70–0.76; p < 0.01) except versus placebo in PIONEER 5 (ETR [95% CI]: 0.83 [0.67–1.03]; p > 0.05). The effect of semaglutide on hsCRP was partially mediated (20.6–61.8%) by change in HbA1c and BW.

Conclusions

Semaglutide reduced hsCRP ratios-to-baseline versus comparators in subjects with type 2 diabetes (not significant with CKD). This effect was partially mediated via reductions in HbA1c and BW and potentially by a direct effect of semaglutide. Semaglutide appears to have an anti-inflammatory effect, which is being further investigated in ongoing trials.

Trial registrations: ClinicalTrials.gov identifiers: NCT01885208 (first registered June 2013), NCT02906930 (first registered September 2016), NCT02863328 (first registered August 2016), NCT02827708 (first registered July 2016).
Real-world evaluation of the Stemoscope electronic tele-auscultation system
Authors: Fan Muge , Wang Qiuli , Liu Jiaqi , Su Lingyun , Wang Bingjian , Xu Hai , Li Qing , Zhang Zhi
Published: September 2022

Background

With the spread of COVID-19, telemedicine has played an important role, but tele-auscultation is still unavailable in most countries. This study introduces and tests a tele-auscultation system (Stemoscope) and compares the concordance of the Stemoscope with the traditional stethoscope in the evaluation of heart murmurs.

Methods

A total of 57 patients with murmurs were recruited, and echocardiographs were performed. Three cardiologists were asked to correctly categorize heart sounds (both systolic murmur and diastolic murmur) as normal vs. abnormal with both the Stemoscope and a traditional acoustic stethoscope under different conditions. Firstly, we compared the in-person auscultation agreement between Stemoscope and the conventional acoustic stethoscope. Secondly, we compared tele-auscultation (recorded heart sounds) agreement between Stemoscope and acoustic results. Thirdly, we compared both the Stemoscope tele-auscultation results and traditional acoustic stethoscope in-person auscultation results with echocardiography. Finally, ten other cardiologists were asked to complete a qualitative questionnaire to assess their experience using the Stemoscope.

Results

For murmurs detection, the in-person auscultation agreement between Stemoscope and the acoustic stethoscope was 91% (p = 0.67). The agreement between Stemoscope tele-auscultation and the acoustic stethoscope in-person auscultation was 90% (p = 0.32). When using the echocardiographic findings as the reference, the agreement between Stemoscope (tele-auscultation) and the acoustic stethoscope (in-person auscultation) was 89% vs. 86% (p = 1.00). The system evaluated by ten cardiologists is considered easy to use, and most of them would consider using it in a telemedical setting.

Conclusion

In-person auscultation and tele-auscultation by the Stemoscope are in good agreement with manual acoustic auscultation. The Stemoscope is a helpful heart murmur screening tool at a distance and can be used in telemedicine.
Short term exposure to air pollution and mortality in the US: a double negative control analysis
Authors: Liu Rongqi Abbie , Wei Yaguang , Qiu Xinye , Kosheleva Anna , Schwartz Joel D.
Published: September 2022

Rationale

Studies examining the association of short-term air pollution exposure and daily deaths have typically been limited to cities and used citywide average exposures, with few using causal models.

Objectives

To estimate the associations between short-term exposures to fine particulate matter (PM2.5), ozone (O3), and nitrogen dioxide (NO2) and all-cause and cause-specific mortality in multiple US states using census tract or address exposure and including rural areas, using a double negative control analysis.

Methods

We conducted a time-stratified case-crossover study examining the entire population of seven US states from 2000–2015, with over 3 million non-accidental deaths. Daily predictions of PM2.5, O3, and NO2 at 1x1 km grid cells were linked to mortality based on census track or residential address. For each pollutant, we used conditional logistic regression to quantify the association between exposure and the relative risk of mortality conditioning on meteorological variables, other pollutants, and using double negative controls.

Results

A 10 μg/m3 increase in PM2.5 exposure at the moving average of lag 0–2 day was significantly associated with a 0.67% (95%CI: 0.34–1.01%) increase in all-cause mortality. 10 ppb increases in NO2 or O3 exposure at lag 0–2 day were marginally associated with and 0.19% (95%CI: −0.01-0.38%) and 0.20 (95% CI-0.01, 0.40), respectively. The adverse effects of PM2.5 persisted when pollution levels were restricted to below the current global air pollution standards. Negative control models indicated little likelihood of omitted confounders for PM2.5, and mixed results for the gases. PM2.5 was also significantly associated with respiratory mortality and cardiovascular mortality.

Conclusions

Short-term exposure to PM2.5 and possibly O3 and NO2 are associated with increased risks for all-cause mortality. Our findings delivered evidence that risks of death persisted at levels below currently permissible.
The new normal for food insecurity? A repeated cross-sectional survey over 1 year during the COVID-19 pandemic in Australia
Authors: Kent Katherine , Murray Sandra , Penrose Beth , Auckland Stuart , Horton Ella , Lester Elizabeth , Visentin Denis
Published: September 2022

Background

Food insecurity during the COVID-19 pandemic has been impacted by necessary public health restrictions. Tasmania, an island state south of the Australian mainland, recorded no community transmission of COVID-19 between May 2020 to November 2021 due to strong border restrictions. This study aimed to determine the changes in prevalence and sociodemographic predictors of food insecurity throughout the COVID-19 pandemic in Tasmania, Australia.

Methods

In May 2020 (survey 1: during lockdown), September 2020 (survey 2: eased restrictions) and May 2021 (survey 3: 1-year post-lockdown), cross-sectional, online surveys using convenience sampling methods determined food insecurity in Tasmanian adults using the USDA Household Food Security Survey Module: Six-Item Short Form, in addition to key sociodemographic questions. Crude and age-adjusted prevalence of food insecurity was calculated, and binary logistic regression determined at-risk groups and changes in prevalence over time.

Results

The age-adjusted prevalence of food insecurity was 27.9% during lockdown (n = 1168), 19.5% when restrictions had eased (n = 1097) and 22.6% 1-year post-lockdown (n = 1100). Young adults, Aboriginal and/or Torres Strait Islander people, individuals with disabilities, families with dependents and temporary residents were at highest risk across all time points.

Conclusions

The prevalence of food insecurity was higher than pre-pandemic levels across all three time points. Our results indicate the potential long-term impacts of the COVID-19 pandemic on food security in Australia, where despite easing social distancing restrictions and a lack of COVID-19 transmission, the prevalence of food insecurity reduced, but did not recover to pre-pandemic levels 1-year following a lockdown.
Competing at the Cybathlon championship for people with disabilities: long-term motor imagery brain–computer interface training of a cybathlete who has tetraplegia
Authors: Korik Attila , McCreadie Karl , McShane Niall , Du Bois Naomi , Khodadadzadeh Massoud , Stow Jacqui , McElligott Jacinta , Carroll Áine , Coyle Damien
Published: September 2022

Background

The brain–computer interface (BCI) race at the Cybathlon championship, for people with disabilities, challenges teams (BCI researchers, developers and pilots with spinal cord injury) to control an avatar on a virtual racetrack without movement. Here we describe the training regime and results of the Ulster University BCI Team pilot who has tetraplegia and was trained to use an electroencephalography (EEG)-based BCI intermittently over 10 years, to compete in three Cybathlon events.

Methods

A multi-class, multiple binary classifier framework was used to decode three kinesthetically imagined movements (motor imagery of left arm, right arm, and feet), and relaxed state. Three game paradigms were used for training i.e., NeuroSensi, Triad, and Cybathlon Race: BrainDriver. An evaluation of the pilot’s performance is presented for two Cybathlon competition training periods—spanning 20 sessions over 5 weeks prior to the 2019 competition, and 25 sessions over 5 weeks in the run up to the 2020 competition.

Results

Having participated in BCI training in 2009 and competed in Cybathlon 2016, the experienced pilot achieved high two-class accuracy on all class pairs when training began in 2019 (decoding accuracy > 90%, resulting in efficient NeuroSensi and Triad game control). The BrainDriver performance (i.e., Cybathlon race completion time) improved significantly during the training period, leading up to the competition day, ranging from 274–156 s (255 ± 24 s to 191 ± 14 s mean ± std), over 17 days (10 sessions) in 2019, and from 230–168 s (214 ± 14 s to 181 ± 4 s), over 18 days (13 sessions) in 2020. However, on both competition occasions, towards the race date, the performance deteriorated significantly.

Conclusions

The training regime and framework applied were highly effective in achieving competitive race completion times. The BCI framework did not cope with significant deviation in electroencephalography (EEG) observed in the sessions occurring shortly before and during the race day. Changes in cognitive state as a result of stress, arousal level, and fatigue, associated with the competition challenge and performance pressure, were likely contributing factors to the non-stationary effects that resulted in the BCI and pilot achieving suboptimal performance on race day.

Trial registration not registered
Oral lichenoid lesion in association with chemotherapy treatment for non-Hodgkin lymphoma or lichen planus? Review of the literature and report of two challenging cases
Authors: Marques Letícia Côgo , de Medeiros Nunes da Silva Laiza Angela , Santos Pâmella de Pinho Montovani , de Almeida Lima Borba Lopes Amanda , Cunha Karin Soares , Milagres Adrianna , Rozza-de-Menezes Rafaela Elvira , Junior Arley Silva , Conde Danielle Castex
Published: September 2022

Background

The diagnosis of oral lichenoid lesions (OLL) remains a challenge for clinicians and pathologists. Although, in many cases, OLL cannot be clinically and histopathologically distinguishable from oral lichen planus (OLP), one important difference between these lesions is that OLL has an identifiable etiological factor, e.g. medication, restorative material, and food allergy. The list of drugs that can cause OLL is extensive and includes anti-inflammatory drugs, anticonvulsants, antihypertensives, antivirals, antibiotics, chemotherapeutics, among others. This work aimed to perform a literature review of OLL related to chemotherapy drugs and to report two cases of possible OLL in patients with B-cell and T-cell non-Hodgkin lymphomas in use of chemotherapy and adjuvant medications. We also discuss the challenge to clinically and histopathologically differentiate OLL and OLP.

Case presentation

In both cases, oral lesions presented reticular, atrophic, erosive/ulcerated, and plaque patterns. The diagnosis of OLL was initially established in both cases by the association of histopathology and history of onset of lesions after the use of medications. Although the patients have presented a significant improvement in the oral clinical picture for more than 2 years of follow-up, they still have some lesions.

Conclusion

A well-detailed anamnesis associated with the drug history, temporal relationship of the appearance of the lesions, and follow-up of patients are fundamental for the diagnosis of OLL related to drugs. Nevertheless, its differentiation from OLP is still a challenge.
Serum level of total histone 3, H3K4me3, and H3K27ac after non-emergent cardiac surgery suggests the persistence of smoldering inflammation at 3 months in an adult population
Authors: Laudanski Krzysztof , Liu Da , Hajj Jihane , Ghani Danyal , Szeto Wilson Y.
Published: September 2022

Background

Despite clinical relevance of immunological activation due to histone leakage into the serum following cardiac surgery, long-term data describing their longitudinal dynamic are lacking. Therefore, this study examines the serum levels of histone 3 (tH3) and its modifications (H3K4me3 and H3K27ac) alongside immune system activation during the acute and convalescence phases of cardiac surgery.

Methods

Blood samples from fifty-nine individuals were collected before non-emergent cardiac surgery (tpre-op) and 24 h (t24hr), seven days (t7d), and three months (t3m) post-procedure to examine serum levels of tH3, H3K4me3, and H3K27ac. Serum heat shock protein-60 (HSP-60) was a surrogate of the cellular damage marker. Serum C-reactive protein (CRP) and interleukin 6 (IL-6) assessed smoldering inflammation. TNFα and IL-6 production by whole blood in response to lipopolysaccharide (LPS) evaluated immunological activation. Electronic medical records provided demographic, peri-operative, and clinical information. Paired longitudinal analyses were employed with data expressed as mean and standard deviation (X ± SD) or median and interquartile range (Me[IQ25; 75%].

Results

Compared to pre-operative levels (tH3Pre-op = 1.6[0.33;2.4]), post-operative serum tH3 significantly (p > 0.0001) increased after heart surgery (tH324hr = 2.2[0.3;28]), remained elevated at 7 days (tH37d = 2.4[0.37;5.3]), and at 3 months (tH33m = 2.0[0.31;2.9]). Serum H3K27ac was elevated at 24 h (H3K27ac24hr = 0.66 ± 0.51;p = 0.025) and seven days (H3K27ac7d = 0.94 ± 0.95;p = 0.032) as compared to baseline hours (H3K27acPre-op = 0.55 ± 0.54). Serum H3K4me3 was significantly diminished at three months (H3K4me3Pre-op = 0.94 ± 0.54 vs. H3K27ac3m = 0.59 ± 0.89;p = 0.008). tH3 correlated significantly with the duration of anesthesia (r2 = 0.38). In contrast, HSP-60 normalized seven days after surgery. Peri-operative intake of acetaminophen, but no acetylsalicylic acid (ASA), acid, ketorolac or steroids, resulted in the significant depression of serum H3K4me3 at 24 h (H3K4me3acetom- = 1.26[0.71; 3.21] vs H3K4me3acetom+ = 0.54[0.07;1.01]; W[50] = 2.26;p = 0.021). CRP, but not IL-6, remained elevated at 3 months compared to pre-surgical levels and correlated with tH324hrs(r2 = 0.43), tH37d(r2 = 0.71;p < 0.05), H3K4me37d(r2 = 0.53), and H3K27ac7d(r2 = 0.49). Production of TNFα by whole blood in response to LPS was associated with serum tH324hrs(r2 = 0.67). Diminished H3K4me324hrs,H3K27ac24hrs, and H3K27ac3m, accompanied the emergence of liver failure.

Conclusions

We demonstrated a prolonged elevation in serum histone 3 three months after cardiac surgery. Furthermore, histone 3 modifications had a discrete time evolution indicating differential immune activation.
Understanding the mechanisms of viral and bacterial coinfections in bovine respiratory disease: a comprehensive literature review of experimental evidence
Authors: Gaudino Maria , Nagamine Brandy , Ducatez Mariette F. , Meyer Gilles
Published: September 2022

Bovine respiratory disease (BRD) is one of the most important diseases impacting the global cattle industry, resulting in significant economic loss. Commonly referred to as shipping fever, BRD is especially concerning for young calves during transport when they are most susceptible to developing disease. Despite years of extensive study, managing BRD remains challenging as its aetiology involves complex interactions between pathogens, environmental and host factors. While at the beginning of the twentieth century, scientists believed that BRD was only caused by bacterial infections (“bovine pasteurellosis”), we now know that viruses play a key role in BRD induction. Mixtures of pathogenic bacteria and viruses are frequently isolated from respiratory secretions of animals with respiratory illness. The increased diagnostic screening data has changed our understanding of pathogens contributing to BRD development. In this review, we aim to comprehensively examine experimental evidence from all existing studies performed to understand coinfections between respiratory pathogens in cattle. Despite the fact that pneumonia has not always been successfully reproduced by in vivo calf modelling, several studies attempted to investigate the clinical significance of interactions between different pathogens. The most studied model of pneumonia induction has been reproduced by a primary viral infection followed by a secondary bacterial superinfection, with strong evidence suggesting this could potentially be one of the most common scenarios during BRD onset. Different in vitro studies indicated that viral priming may increase bacterial adherence and colonization of the respiratory tract, suggesting a possible mechanism underpinning bronchopneumonia onset in cattle. In addition, a few in vivo studies on viral coinfections and bacterial coinfections demonstrated that a primary viral infection could also increase the pathogenicity of a secondary viral infection and, similarly, dual infections with two bacterial pathogens could increase the severity of BRD lesions. Therefore, different scenarios of pathogen dynamics could be hypothesized for BRD onset which are not limited to a primary viral infection followed by a secondary bacterial superinfection.
Effect of β-1,3/1,6-glucan on gut microbiota of yellow-feathered broilers
Authors: Wang Jingge , Zheng Zibin , Yang Hua , Chen Jie , Xiao Yingping , Ji Xiaofeng , Zhang Zhenming , He Hailian , Ding Baoan , Tang Biao
Published: September 2022

β-1,3/1,6-glucan as a prebiotic improves immune performance in animals. These functions are closely related to the effect of β-1,3/1,6-glucan on gut microbiota structure. However, the effect of β-1,3/1,6-glucan on the gut microbiota structure of broilers is unclear. The aim of this study was to confirm the effects of β-1,3/1,6-glucan on the cecal microflora structure of yellow-feathered broilers. This study monitored the antimicrobial resistance (AMR) level of Escherichia coli in feces of yellow-feathered broilers by standard broth dilution method and mastered the AMR level of chickens selected. The effects of β-1,3/1,6-glucan on gut microbiota were investigated by 16S rRNA sequencing. The results showed that the number of isolated multidrug-resistant E. coli strains accounted for 98.41%. At 14, 21, and 28 days of age, supplemented of 0.2%, 0.1%, and 0.1% β-1,3/1,6-glucan in yellow-feathered broiler diets significantly altered gut microbial composition, and beneficial bacteria Alistipes, Bacteroides and Faecalibacterium were significantly increased. These findings provide guidance and recommendations for β-1,3/1,6-glucan as a broiler feed additive to improve the growth of broilers.
Stress-constrained topology optimization using approximate reanalysis with on-the-fly reduced order modeling
Authors: Xiao Manyu , Ma Jun , Lu Dongcheng , Raghavan Balaji , Zhang Weihong
Published: September 2022

Most of the methods used today for handling local stress constraints in topology optimization, fail to directly address the non-self-adjointness of the stress-constrained topology optimization problem. This in turn could drastically raise the computational cost for an already large-scale problem. These problems involve both the equilibrium equations resulting from finite element analysis (FEA) in each iteration, as well as the adjoint equations from the sensitivity analysis of the stress constraints. In this work, we present a paradigm for large-scale stress-constrained topology optimization problems, where we build a multi-grid approach using an on-the-fly Reduced Order Model (ROM) and the p-norm aggregation function, in which the discrete reduced-order basis functions (modes) are adaptively constructed for adjoint problems. In addition to reducing the computational savings due to the ROM, we also address the computational cost of the ROM learning and updating phases. Both reduced-order bases are enriched according to the residual threshold of the corresponding linear systems, and the grid resolution is adaptively selected based on the relative error in approximating the objective function and constraint values during the iteration. The tests on 2D and 3D benchmark problems demonstrate improved performance with acceptable objective and constraint violation errors. Finally, we thoroughly investigate the influence of relevant stress constraint parameters such as the p norm factor, stress penalty factor, and the allowable stress value.
Induction of cellulase production by Sr2+ in Trichoderma reesei via calcium signaling transduction
Authors: Li Ni , Zeng Yi , Chen Yumeng , Shen Yaling , Wang Wei
Published: September 2022

Trichoderma reesei RUT-C30 is a well-known high-yielding cellulase-producing fungal strain that converts lignocellulose into cellulosic sugar for resource regeneration. Calcium is a ubiquitous secondary messenger that regulates growth and cellulase production in T. reesei. We serendipitously found that adding Sr2+ to the medium significantly increased cellulase activity in the T. reesei RUT-C30 strain and upregulated the expression of cellulase-related genes. Further studies showed that Sr2+ supplementation increased the cytosolic calcium concentration and activated the calcium-responsive signal transduction pathway of Ca2+–calcineurin-responsive zinc finger transcription factor 1 (CRZ1). Using the plasma membrane Ca2+ channel blocker, LaCl3, we demonstrated that Sr2+ induces cellulase production via the calcium signaling pathway. Supplementation with the corresponding concentrations of Sr2+ also inhibited colony growth. Sr2+ supplementation led to an increase in intracellular reactive oxygen species (ROS) and upregulated the transcriptional levels of intracellular superoxide dismutase (sod1) and catalase (cat1). We further demonstrated that ROS content was detrimental to cellulase production, which was alleviated by the ROS scavenger N-acetyl cysteine (NAC). This study demonstrated for the first time that Sr2+ supplementation stimulates cellulase production and upregulates cellulase genes via the calcium signaling transduction pathway. Sr2+ leads to an increase in intracellular ROS, which is detrimental to cellulase production and can be alleviated by the ROS scavenger NAC. Our results provide insights into the mechanistic study of cellulase synthesis and the discovery of novel inducers of cellulase.

Graphical Abstract
Quintuply-fortified salt for the improvement of micronutrient status among women of reproductive age and preschool-aged children in Punjab, India: protocol for a randomized, controlled, community-based trial
Authors: McDonald Christine M. , Brown Kenneth H. , Goh Yvonne E. , Manger Mari S. , Arnold Charles D. , Krebs Nancy F. , Westcott Jamie , Long Julie M. , Gibson Rosalind S. , Jamwal Manu , Singh Bidhi L. , Dahiya Neha , Budhija Deepmala , Das Reena , Duggal Mona
Published: September 2022

Background

Multiple micronutrient (MN) deficiencies remain highly prevalent among women of reproductive age (WRA) and preschool-aged children (PSC) in many areas within India. Salt is an attractive vehicle for MN fortification in this context, as it is universally consumed in fairly consistent amounts and coverage of iodized salt (IS) is 94%. The overall objective of this trial is to evaluate the nutritional impact of quintuply-fortified salt with iron in the form of encapsulated ferrous fumarate, zinc, vitamin B12, folic acid, and iodine (eFF-Q5S) vs. quintuply-fortified salt with iron in the form of ferric pyrophosphate plus EDTA, zinc, vitamin B12, folic acid, and iodine (FePP-Q5S) vs. IS for the improvement of MN status among non-pregnant WRA and PSC.

Methods

The study is a community-based, randomized, controlled trial that will be conducted in Punjab, India. 780 non-pregnant WRA 18–49 years old and 468 PSC 12–59 months old will be enrolled and assigned to one of three intervention groups. Salt will be provided to participants monthly for 12 months. Primary outcomes include changes in mean concentration of biomarkers of iron, zinc, vitamin B12, folate and iodine. Secondary outcomes include changes in the composition of the gut microbiome, and discretionary salt intake of PSC.

Discussion

If proven efficacious, multiply-fortified salt (MFS) has the potential to drastically reduce the burden of MN deficiencies in India, and around the world. Although effectiveness research will be needed to examine the impact of MFS under programmatic conditions, salt fortification will piggy-back on existing platforms to produce IS and doubly-fortified salt (DFS), making it possible to scale-up the intervention quickly.

Trial registration

Clinicaltrials.gov: NCT05166980; date of registration: December 22, 2021. Clinical Trials Registry-India: CTRI/2022/040332 and CTRI/2022/02/040333; date of registration: February 15, 2022.
Dysmenorrhea and depressive symptoms among female university students: a descriptive study from Saudi Arabia
Authors: Alateeq Deemah , Binsuwaidan Lolwah , Alazwari Leenah , Algarni Maram , Al Hussain Maryam , Alzahrani Raghad , Aljohani Reema
Published: September 2022

Background

Dysmenorrhea has significantly increased in prevalence. There is also evidence of the coexistence of dysmenorrhea and psychological disorders. This study aims to explore the prevalence of dysmenorrhea and investigate its correlation with depressive symptoms among Princess Nourah bint Abdulrahman University (PNU) students. All participants (N = 487) in this cross-sectional study provided sociodemographic data, menstrual and medical history, and completed the Patient Health Questionnaire (PHQ-9) scale and (working ability, location, intensity, days of pain, dysmenorrhea [WaLIDD]) scale on a self-administered online questionnaire.

Results

The mean age of the females was 20.64 ± 2.38 years, and 40.7% were from health colleges. Severe dysmenorrhea requiring medical attention and pain killers or herbs was reported by 30.8% of the students. Significant predictors of severe dysmenorrhea were: younger age, earlier menarche, pain killers and herbs used for menstrual pain, a doctor visit for menstrual pain, and depression. In addition, significant protective factors of depression were: later menarche age, having a regular menstrual cycle, and longer duration.

Conclusions

Students with severe dysmenorrhea have a higher risk of depression than other students. The findings stress the importance of awareness, education, a multidisciplinary approach to women's health, and early detection to prevent future complications.
The role of antibiotic calcium sulfate beads in acute periprosthetic knee infection: a retrospective cohort study
Authors: Piovan Gianluca , Farinelli Luca , Screpis Daniele , Marocco Stefania , Motta Leonardo , Palazzolo Giuseppe , Natali Simone , Zorzi Claudio
Published: September 2022

Background

The study aimed to compare debridement, antibiotics, and implant retention (DAIR) vs. debridement antibiotic bead and retention of the implant (DABRI) in terms of infection-free success rate and treatment cost for acute periprosthetic joint infections after total knee arthroplasty (TKA).

Method

Between 2017 and 2020, 32 patients with acute periprosthetic joint infection who were treated by total knee arthroplasty were retrospectively reviewed. The patients were divided into a DAIR group (n=15) and a DABRI group (n=17). During the DABRI, additional calcium ulphate antibiotic beads were used. Patient age, the Musculoskeletal Infection Society score, microorganisms involved, and success rate were assessed.

Results

The mean age of DAIR group (n=15) was 69 years, with 7 being male, and 8 female. The mean follow-up period lasted 30 months. The success rate was 80% (12/15). The mean age of DABRI group (n=17) was 64 years, with 10 patients being male and 7 female. The mean follow-up period was 16 months. The success rate was 88% (15/17). There were no significant differences in patient age (P>0.05), the Musculoskeletal Infection Society score (P>0.05), and success rate (P>0.05). A significant difference was found in the follow-up period between the two groups (P<0.05).

Conclusion

Both DAIR and DABRI could be used to treat acute periprosthetic joint infections and the outcomes and treatment costs of the two procedures were comparable. Additional use of calcium sulfate beads was safe, but might not improve the treatment result. Randomized controlled studies are warranted for the routine use.
Vitamin D levels and menopause-related symptoms in postmenopausal women
Authors: Hakim Noaman H. , Mohamed Mariam L. , El-Biely Magda M. , Taha Omima T. , Hassan Ahmed
Published: September 2022

Background

Menopause is an important period in women’s life. It is characterized by many symptoms that affect women’s quality of life. This study aimed to the evaluation of the relation between vitamin D levels and menopause-related symptoms. 

Results

Vitamin D insufficiency was noted in 52.4% of the studied population. There was no statistically significant difference in any of the menopausal rating scale dimensions, psychological symptoms (p = 0.16), somato-vegetative symptoms (p = 0.45), or urogenital symptoms (p = 0.59), between vitamin D sufficient and insufficient groups. The severity of the menopausal symptoms was affected by the presence of medical illness (p < 0.001).

Conclusion

Vitamin D deficiency is an alarming issue among postmenopausal women. It was not associated with menopause-related symptoms.
Evolutionary urban resilience as an incremental approach to sustainability: a multifunctional pluvial flood and wastewater risk reduction framework
Authors: Elsharqawy Hafsa Refaey , Elbarmelgy Mohamed Mohamed , Elmalt Ahmed Esam
Published: September 2022

After the increasing climate change and fast urbanization adverse effects on pluvial floods, in addition to the freshwater resources’ shortage risk, transversal urban solutions need to be tackled. This paper focuses on how the evolutionary urban resilience practices (along with the nature-based solutions and climate change adaptation) work as an integrated approach to enhance multifunctionality levels of sustainable urban planning and design. This integration eventually leads to more pluvial flood-resilient cities and more sustainable urban water resources simultaneously. After thoroughly analyzing related literature and best practices using descriptional, comparative, and statistical approaches, a proposed risk reduction framework that facilitates the resilience operationalizing process was formulated. The proposed framework introduces a design equation that measures the relationship between sustainability and urban resilience sectors. In addition to that, prioritized strategies for enhancing flood resilience and urban wastewater management within the Egyptian local scale were ranked for future applications.
Super-resolution imaging of Maxwell’s fish-eye lens based on surface polaritons
Authors: Chen Shuqi , Li Jue , Zhou Yangyang , Hao Zhanlei , Duan Qilin , Chen Huanyang
Published: September 2022

Super-resolution imaging plays a crucial role in the fields of nanolithography, high volume transmission and sensing. Relentless efforts have been made to realize super-resolution imaging in the past decades. In this work, inspired by the mechanism of surface plasmon polaritons (SPPs), we find that Maxwell’s fish-eye lens (MFEL) coated with cylindrical layer of negative permeability can achieve super-resolution imaging. The amplification of evanescent waves in the negative permeability layer facilitates the transmittance of high spatial frequency information from object point to imaging point in the form of magnetic surface polaritons (MSPs). Both analytical calculations and numerical simulations are employed to prove the super-resolution imaging performance of MSPs-assisted MFEL. Our results may pave a new way for super-resolution imaging in metallic systems.
Unwritten Virtues, Selves, and Texts: Early Modern Self-Erasure
Authors: Simpson James
Published: September 2022

The tradition that became liberalism, which claims to have promoted meritocracy and individual agency, was, in both evangelical origin and in a one-hundred-fifty-year tradition thereafter, unremittingly hostile to the claims of human merit and agency upon God. This hostility is considered from three discursive angles: legislation, poetry, and pastoralia. Between at least 1571 and 1660 the English state legislated against confidence in the salutary value of humanly produced virtue. Early modern elegiac poetry evinces the attempted dissolution of evangelical selfhood and the inevitable twin of that desired dissolution: the unraveling of discursive confidence that must accompany, and perhaps produces, the desire for self-dissolution. Elegiac writing unwrites itself. The article then looks behind the literature to the pastoral incitation to crush both selfhood and the self's habitual, agential understandings of language.
Calvinist Versions of God: A Revolution in Medieval Tradition
Authors: Aers David
Published: September 2022

This essay argues that Calvinist versions of God and human redemption cannot be adequately grasped without studying the medieval traditions from which they emerged. Beginning with a close reading of Calvin's extremely violent understanding of the atonement, the essay moves through examinations of medieval versions of human redemption (literary, theological, and devotional) before turning to the political and ethical consequences of Calvin's reformation of these versions of God as played out in the Cromwellian regime of the mid-seventeenth century. Finally, the essay explores the reemergence of a version of God and charity recognizable to medieval readers in the writings of the “Ranter” Abiezer Coppe. Throughout, the essay demonstrates how models of redemption with their attendant versions of God have clear consequences for ethics and politics.
Drosophila CRISPR/Cas9 mutants as tools to analyse cardiac filamin function and pathogenicity of human FLNC variants
Authors: Ader F. , Russi M. , Tixier-Cardoso L. , Jullian E. , Martin E. , Richard P. , Villard E. , Monnier V.
Published: September 2022

Filamins are large proteins with actin binding properties. Mutations in FLNC, one of the three filamin genes in humans, have recently been implicated in dominant cardiomyopathies, but the underlying mechanisms are not well understood. Here, we aimed to use Drosophila melanogaster as a new in vivo model to study these diseases. First, we show that adult-specific cardiac RNAi-induced depletion of Drosophila Filamin (dFil) induced cardiac dilatation, impaired systolic function and sarcomeric alterations, highlighting its requirement for cardiac function and maintenance of sarcomere integrity in the adult stage. Next, we introduced in the cheerio gene, using CRISPR/Cas9 gene editing, three missense variants, previously identified in patients with hypertrophic cardiomyopathy. Flies carrying these variants did not exhibit cardiac defects or increased propensity to form filamin aggregates, arguing against their pathogenicity. Finally, we show that deletions of the C-term part of dFil carrying the last four Ig-like domains are dispensable for cardiac function. Collectively, these results highlight the relevance of this model to explore the cardiac function of filamins and increase our understanding of physio-pathological mechanisms involved in FLNC-related cardiomyopathies.
Suction feeding of West African lungfish (Protopterus annectens): An XROMM analysis of jaw mechanics, cranial kinesis, and hyoid mobility
Authors: Gartner Samantha M. , Whitlow Katrina R. , Laurence-Chasen J. D. , Kaczmarek Elska B. , Granatosky Michael C. , Ross Callum F. , Westneat Mark W.
Published: September 2022

Suction feeding in fishes is characterized by rapid cranial movements, but extant lungfishes (Sarcopterygii: Dipnoi) exhibit a reduced number and mobility of cranial bones relative to actinopterygian fishes. Despite fusion of cranial elements, lungfishes are proficient at suction feeding, though the impacts of novel cranial morphology and reduced cranial kinesis on feeding remain poorly understood. We used X-ray reconstruction of moving morphology (XROMM) to study the kinematics of seven mobile elements (neurocranium, upper jaw, lower jaw, tongue, ceratohyal, clavicle, and cranial rib) and two muscles (costoclavicular portion of the hypaxialis and rectus cervicis) during the feeding strikes of West African lungfish (Protopterus annectens). We found that feeding by P. annectens on non-evasive prey is relatively slow, with a mean time to peak gape of 273 ms. Lower jaw depression and clavicular rotation were hinge-like, with one degree of freedom, but the ceratohyals rotated in a complex motion involving depression and long-axis rotation. We quantified the relative contributions to oral cavity volume change (RCVC) and found that oral cavity expansion is created primarily by ceratohyal and clavicle motion. P. annectens suction feeds relatively slowly but successfully through muscle shortening of hypaxial and rectus cervicis muscles contributing to hyoid mobility.
Prevalence of Musculoskeletal, Neurological and Physical Disorder After COVID-19 in Saudi Arabia: A Cross Sectional Study
Authors: Mahmoud Hayam , Ebid Anwar , Alghamdi Mohammed , Ibrahim Abeer , Almoosa Ahmed
Published: September 2022

Background: The global pandemic of SARS-CoV-2, or COVID-19 continues to attack all human systems. Although COVID-19 is a respiratory disease, various extra-pulmonary manifestations, including musculoskeletal and neuropathies/myopathies was reported. This study aimed to investigates the long-term impacts of COVID-19 infection on physical health, capability of daily life activities, musculoskeletal and neurological functions in the Kingdom of Saudi Arabia (KSA). Methods: A total of 499 adults recovered from COVID-19 infection of both sexes, who resided in the KSA were recruited randomly and invited to participate in this cross-sectional web-based survey. A self-administered structured questionnaire was used as an instrument of data collection. All respondents returned the questionnaire. Their responses were recorded, stored into a Microsoft Excel sheet 2010 and analyzed with the Statistical Package for the Social Sciences (SPSS) version 24. Percentages were used to convey descriptive data. The percentages were presented with a 95% confidence interval (CI). For statistical significance, a 0.05 p-value was used. Results: The overall prevalence of neurological and musculoskeletal disorders as follows: headache (63.1%), muscle ache or weakness (62.3%), vertigo (25%), concentration problems (21.8%), breathing troubles (20.4%), loss of balance (19.4%), seizure (1%), and Guillain-Barre Syndrome (0.6%). The results also revealed a significant association between the influence of COVID-19 infection and daily activities, gender and respiratory disorders. Conclusion: The findings highlighted and concluded that COVID-19 infection had an impact on respiratory, nervous, musculoskeletal systems and affect daily activities.