bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiac Risk Factors for Stroke: A Comprehensive Mendelian Randomization Study
Authors: Frerich Simon , Malik Rainer , Georgakis Marios K. , Sinner Moritz F. , Kittner Steven J. , Mitchell Braxton D. , Dichgans Martin
Published: December 2021

Background:

Observational studies suggest an association of stroke with cardiac traits beyond atrial fibrillation, the leading source of cardioembolism. However, controversy remains regarding a causal role of these traits in stroke pathogenesis. Here, we leveraged genetic data to systematically assess associations between cardiac traits and stroke risk using a Mendelian Randomization framework.

Methods:

We studied 66 cardiac traits including cardiovascular diseases, magnetic resonance imaging–derived cardiac imaging, echocardiographic imaging, and electrocardiographic measures, as well as blood biomarkers in a 2-sample Mendelian Randomization approach. Genetic predisposition to each trait was explored for associations with risk of stroke and stroke subtypes in data from the MEGASTROKE consortium (40 585 cases/406 111 controls). Using multivariable Mendelian Randomization, we adjusted for potential pleiotropic or mediating effects relating to atrial fibrillation, coronary artery disease, and systolic blood pressure.

Results:

As expected, we observed strong independent associations between genetic predisposition to atrial fibrillation and cardioembolic stroke and between genetic predisposition to coronary artery disease as a proxy for atherosclerosis and large-artery stroke. Our data-driven analyses further indicated associations of genetic predisposition to both heart failure and lower resting heart rate with stroke. However, these associations were explained by atrial fibrillation, coronary artery disease, and systolic blood pressure in multivariable analyses. Genetically predicted P-wave terminal force in V1, an electrocardiographic marker for atrial cardiopathy, was inversely associated with large-artery stroke.

Conclusions:

Available genetic data do not support substantial effects of cardiac traits on the risk of stroke beyond known clinical risk factors. Our findings highlight the need to carefully control for confounding and other potential biases in studies examining candidate cardiac risk factors for stroke.
Implicit Contact Dynamics Modeling With Explicit Inertia Matrix Representation for Real-Time, Model-Based Control in Physical Environment
Authors: Itoh Takeshi D. , Ishihara Koji , Morimoto Jun
Published: December 2021

Model-based control has great potential for use in real robots due to its high sampling efficiency. Nevertheless, dealing with physical contacts and generating accurate motions are inevitable for practical robot control tasks, such as precise manipulation. For a real-time, model-based approach, the difficulty of contact-rich tasks that requires precise movement lies in the fact that a model needs to accurately predict forthcoming contact events within a limited length of time rather than detect them afterward with sensors. Therefore, in this study, we investigate whether and how neural network models can learn a task-related model useful enough for model-based control, that is, a model predicting future states, including contact events. To this end, we propose a structured neural network model predictive control (SNN-MPC) method, whose neural network architecture is designed with explicit inertia matrix representation. To train the proposed network, we develop a two-stage modeling procedure for contact-rich dynamics from a limited number of samples. As a contact-rich task, we take up a trackball manipulation task using a physical 3-DoF finger robot. The results showed that the SNN-MPC outperformed MPC with a conventional fully connected network model on the manipulation task.
Distributed Phase Oscillatory Excitation Efficiently Produces Attractors Using Spike-Timing-Dependent Plasticity
Authors: Wong Eric C.
Published: December 2021

The brain is thought to represent information in the form of activity in distributed groups of neurons known as attractors. We show here that in a randomly connected network of simulated spiking neurons, periodic stimulation of neurons with distributed phase offsets, along with standard spike-timing-dependent plasticity (STDP), efficiently creates distributed attractors. These attractors may have a consistent ordered firing pattern or become irregular, depending on the conditions. We also show that when two such attractors are stimulated in sequence, the same STDP mechanism can create a directed association between them, forming the basis of an associative network. We find that for an STDP time constant of 20 ms, the dependence of the efficiency of attractor creation on the driving frequency has a broad peak centered around 8 Hz. Upon restimulation, the attractors self-oscillate, but with an oscillation frequency that is higher than the driving frequency, ranging from 10 to 100 Hz.
“Killing for Show”: A Conversation with Julian Stallabrass
Authors: Nixon Mignon
Published: December 2021

In this conversation prompted by the publication of Julian Stallabrass's Killing for Show: Photography, War and the Media in Vietnam and Iraq (Rowman & Littlefield, 2021), Stallabrass and Mignon Nixon discuss the roles played by photography in two wars that, Stallabrass contends, were simultaneously staged for, and concealed from, the camera. The discussion encompasses diverse modes of war photography, from photojournalism and official military photography to amateur and trophy images, aftermath photographs, and found images used by contemporary artists. It dwells on questions of memory, systemic cruelty, trauma, and melancholy, and on shifts in technology, media, and social relations that have altered the dynamics of killing for show over time, without eliminating the imperative.
Just metamorphosed amphibians: imagos or metamorphs?
Authors: DUBOIS ALAIN
Published: December 2021

The term metamorph for just metamorphosed amphibians appeared surreptitiously in the batrachological literature. It is shown here that this term is linguistically unjustified and conceptually confusing, as it has never been associated with a clear, formal definition stating in particular when does this developmental stage start and end. The use of the term imago for an individual resulting from the last metamorphosis following a larval stage, which exists for insects since 1767 and for amphibians since 1808, is much preferable. For amphibians, the formal definition of this term was given in 1978 as an animal having completed its metamorphosis, before having substantially grown and until the first major ecological event in its life cycle (such as migration, hibernation or aestivation). In amphibians, this stage is followed by a stage juvenile and a stage subadult until the stage adult is reached, which is defined by sexual maturity and ability to reproduce. Given the diversity of developmental modes in the animal kingdom, it would be vain to try to homogenise the terminology of all detailed developmental stages across all groups. However, the possibility to homogenise the use of the term imago throughout zoology for specimens resulting from the ‘last metamorphosis’ (i.e., drastic change not only of form but also in some anatomical structures), whether followed by growth and minor transformations or not, and whether associated with sexual maturity or not, would certainly be worth considering. This would allow to have a few general descriptive terms to designate the main similar, but not homologous, ‘landmarks’ observed in the development of many animals (egg, larva, imago and adult), just like we have a general term (metamorphosis) for ‘similar’ phenomena which are not homologous. This would not prevent specialists of the various zoological groups to have specific terms for more precisely defined ‘stages’ which are proper to these groups.
The correct name for the North African rock lizard is Agama bibronii A. Duméril in Duméril & Duméril, 1851, not Agama impalearis Boettger, 1874 (Reptilia, Squamata)
Authors: DENZER WOLFGANG
Published: December 2021

Over half a century ago, Mertens (1955) noted that the name Agama bibronii A. Duméril in Duméril & Duméril, 1851 for a North African agamid lizard species was preoccupied by Trapelus (Psammorrhoa) bibronii Fitzinger, 1843, a species inhabiting South Africa. He consequently stated that the next available name for Agama bibronii ‘Duméril, 1851’, namely Agama colonorum var. impalearis Boettger, 1874 should be applied to this taxon. Until today, the herpetological literature contains examples where either Agama bibronii ‘Duméril, 1851’ or Agama impalearis Boettger, 1874 is used to denominate the North African rock agama. However, an apparently overlooked ruling by the Commission suppressed the name Trapelus (Psammorrhoa) bibronii Fitzinger, 1843, so that Agama bibronii A. Duméril in Duméril & Duméril, 1851 is the valid name for the North African rock agama.
Conversion of the names Pyxicephaloidea, Pyxicephalidae and Pyxicephalinae (Anura, Ranoidea) into phylogenetic nomenclature
Authors: LEMIERRE ALFRED , LAURIN MICHEL
Published: December 2021

The recent publications of the sixth edition of the PhyloCode and of the monograph Phylonyms now allow the publication of nomenclatural acts that will establish priority under that code. This includes defining existing and newly proposed taxon names in conformity with the PhyloCode. Among amphibian taxa, very few names have been converted so far, and we take the opportunity of our recent phylogenetic analysis of neobatrachians focusing on an extinct genus of Pyxicephalidae, Thaumastosaurus, from the Eocene of Western Europe, to convert the names Pyxicephaloidea, Pyxicephalidae and Pyxicephalinae into phylogenetic nomenclature, following the PhyloCode rules.
Checklist of conspicuous reef fishes of the Bahía de los Ángeles region, Baja California Norte, Mexico, with comments on abundance and ecological biogeography
Authors: MASCAREÑAS-OSORIO ISMAEL , ERISMAN BRAD , MOXLEY JERRY , BALART EDUARDO , ABURTO-OROPEZA OCTAVIO
Published: December 2021

A first checklist of conspicuous reef fishes observed at 15 sites in the vicinity of Bahía de los Ángeles from 2008 to 2010 is presented. A total of 70 species representing 31 families were observed. Species composition was similar to well studied regions in the southern Gulf of California, in that most species had distributions that span the Tropical Eastern Pacific but species endemic to Mexico or the Gulf of California ranked highest in relative abundance, frequency of occurrence, and mean density. Several species with temperate geographic distributions were more abundant and frequent than on reefs in the southern Gulf. Large-bodied, predatory species such as sharks and the Gulf Grouper, Mycteroperca jordani, were rare or absent.
Nomenclatural itch versus patrolling itch: comments on O’Hara (2011)
Authors: NEMÉSIO ANDRÉ
Published: December 2021

In the last years there have been renewed criticisms towards those who, theoretically, abuse of naming new taxa, supposedly with the only (or main) objective of having their names associated to the nomina of these taxa and, thus, being ‘immortalized’ (Pillon & Chase 2007[1]; Dubois 2008; Evenhuis 2008). As Evenhuis (2008) has carefully shown, however, this kind of criticism is almost as old as taxonomy itself and those erecting supposedly unnecessary nomina are often considered to be suffering the mihi itch (‘mihi’ is the Latin for ‘to me’, alluding to an egotistical affliction). In fact, even Linnaeus has been later indirectly accused of being afflicted by the mihi itch: “It has often been pointed out that Linnaeus had no idea of a principle of priority. Indeed, he was in no moral position to hold any such idea, engaged as he was in rejecting nearly all existing names of species” (Melville 1995: 5) and, of course, giving them nomina of his own.
Socioeconomic Determinants of Maternal HealthCare Utilisation in Zambia: 1997-2014
Authors: He Zhifei , Zhang Caihua , Wang Shiming , Bishwajit Ghose , Yang Xinglong
Published: December 2021

This study aims at exploring the trends and socioeconomic inequalities in the use of maternal healthcare utilization between 1997 and 2014. Data were analyzed using descriptive and multivariate regression methods. Women in the higher wealth quintiles (Q4 and Q5) generally had higher prevalence of using health facility delivery and postnatal care services compared with those in the lower wealth quintiles (Q1 and Q2), whereas the prevalence of timely and adequate antenatal care visit was comparatively higher among those in the lower wealth quintiles. Findings indicated important sociodemographic inequalities in using maternal healthcare services, addressing which may help promote the utilization of these services.
Do it yourself: The role of early self-care ability in social skills in Japanese preschool settings
Authors: Zhu Zhu , Tanaka Emiko , Tomisaki Etsuko , Watanabe Taeko , Sawada Yuko , Li Xiang , Jiao Dandan , Ajmal Ammara , Matsumoto Munenori , Zhu Yantong , Anme Tokie
Published: December 2021

Self-care ability and social skills are potential areas of difficulty for preschool children. However, values about young children's self-care ability are different worldwide. This longitudinal study examined the influence of early self-care ability on social skills at the end of the preschool years. Participants were 509 children recruited from kindergartens and child care centers across Japan, whose self-care ability and social skills were assessed at baseline year and three years later (Age of children in 2015 at baseline: M  =  35 months, SD  =  6.1 months). The study found that gender was significantly associated with social skills, while preschool facility entrance age was only associated with assertion skills. After controlling gender and entrance age, early self-care ability was still positively related to later assertion and cooperation (Assertion: OR  =  2.55, 95% CI  =  1.00–6.51; Cooperation: OR  =  3.15, 95% CI  =  1.23–8.07). Implications of the findings are discussed in the context of cultural diversity, highlighting the importance of cultivating children's age-appropriate self-care ability based on daily observations and evaluations.
Increase in cartilage degeneration in all knee compartments after failed ACL reconstruction at 4 years of follow-up
Authors: Andrä Kathleen , Prill Robert , Kayaalp Enes , Irlenbusch Lars , Liesaus Eckehard , Trommer Tilo , Ullmann Peter , Becker Roland
Published: December 2021

Purpose

Degeneration of the cartilage after anterior cruciate ligament reconstruction (ACL-R) is known, and further deterioration can be expected in patients with tunnel malplacement or partial meniscal resection. It was hypothesized that there is a significant increase in cartilage degeneration after failed ACL-R.

Material and methods

Isolated ACL revision surgery was performed in 154 patients at an interval of 46 ± 33 months (5–175 months) between primary and revision surgery. Cartilage status at the medial, lateral femorotibial, and patellofemoral compartments were assessed arthroscopically during primary and revision ACL-R in accordance with the Outerbridge classification. Tunnel placement, roof angle, and tibial slope was measured using anteroposterior and lateral radiographic views.

Results

Cartilage degeneration increased significantly in the medial femorotibial compartment, followed by the lateral and patellofemoral compartments. There was a correlation between both cartilage degeneration in the patellofemoral compartment (PFC) (rs = 0.28, p = 0.0012) and medial tibial plateau (Rs = 0.24, p = 0.003) in relation to the position of tibial tunnel in the frontal plane. Worsening of the cartilage status in the medial femorotibial compartment, either femoral or tibial, was correlated with the tibial aperture site in the lateral view (Rs = 0.28, p < 0.001). Cartilage degeneration in the lateral compartment of the knee, on both femoral or tibial side, was inversely correlated with the femoral roof angle (Rs = −0.1985, p = 0.02). Meniscal tears, either at the medial or lateral site or at both, were found in 93 patients (60%) during primary ACL-R and increased to 132 patients (86%) during revision ACL-R.

Discussion

Accelerated cartilage degeneration and high prevalence of meniscal lesions are seen in failed ACL-R. Tunnel placement showed significant impact on cartilage degeneration and may partially explain the increased risk of an inferior outcome when revision surgery is required after failed primary ACL-R.

Level of evidence: Level IV—retrospective cohort study.
Proteomics and functional study reveal kallikrein-6 enhances communicating hydrocephalus
Authors: Yuan Lei , Zou Dongdong , Yang Xia , Chen Xin , Lu Youming , Zhang Aijun , Zhang Pengqi , Wei Fance
Published: December 2021

Background

Communicating hydrocephalus (CH) is a common neurological disorder caused by a blockage of cerebrospinal fluid. In this study, we aimed to explore the potential molecular mechanism underlying CH development.

Methods

Quantitative proteomic analysis was performed to screen the differentially expressed proteins (DEPs) between patients with and without CH. A CH rat model was verified by Hoechst staining, and the co-localization of the target protein and neuron was detected using immunofluorescence staining. Loss-of-function experiments were performed to examine the effect of KLK6 on the synapse structure.

Results

A total of 11 DEPs were identified, and kallikrein 6 (KLK6) expression was found to be significantly upregulated in patients with CH compared with that in patients without CH. The CH rat model was successfully constructed, and KLK6 was found to be co-localized with neuronal nuclei in brain tissue. The expression level of IL-1β, TNF-α, and KLK6 in the CH group was higher than that in the control group. After knockdown of KLK6 expression using small-interfering RNA (siRNA), the expression levels of synapsin-1 and PSD95 in neuronal cells were increased, and the length, number, and structure of synapses were significantly improved. Following siRNA interference KLK6 expression, 5681 differentially expressed genes (DEGs) were identified in transcriptome profile. The upregulated DEGs of Appl2, Nav2, and Nrn1 may be involved in the recovery of synaptic structures after the interference of KLK6 expression.

Conclusions

Collectively, KLK6 participates in the development of CH and might provide a new target for CH treatment.
The gut microbiome as an indicator of habitat disturbance in a Critically Endangered lemur
Authors: McManus Nicolette , Holmes Sheila M. , Louis Edward E. , Johnson Steig E. , Baden Andrea L. , Amato Katherine R.
Published: December 2021

Background

Habitat disturbance affects the biology and health of animals globally. Understanding the factors that contribute to the differential responses of animals to habitat disturbance is critical for conservation. The gut microbiota represents a potential pathway through which host responses to habitat disturbance might be mediated. However, a lack of quantitative environmental data in many gut microbiome (GM) studies of wild animals limits our ability to pinpoint mechanisms through which habitat disturbance affects the GM. Here, we examine the impact of anthropogenic habitat disturbance on the diet and GM of the Critically Endangered black-and-white ruffed lemur (Varecia variegata editorum). We collected fecal samples and behavioral data fromVareciaoccupying habitats qualitatively categorized as primary forest, moderately disturbed forest, and heavily disturbed forest.

Results

Vareciadiet and GM composition differed substantially across sites. Dietary richness predicted GM richness across sites, and overall GM composition was strongly correlated to diet composition. Additionally, the consumption of three specific food items positively correlated to the relative abundances of five microbial strains and one microbial genus across sites. However, diet did not explain all of the GM variation in our dataset, and differences in the GM were detected that were not correlated with diet, as measured.

Conclusions

Our data suggest that diet is an important influence on theVareciaGM across habitats and thus could be leveraged in novel conservation efforts in the future. However, other factors such as contact with humans should also be accounted for. Overall, we demonstrate that quantitative data describing host habitats must be paired with GM data to better target the specific mechanisms through which environmental change affects the GM.
Isolation and functional characterization of a glucose-6-phosphate/phosphate translocator (IbG6PPT1) from sweet potato (Ipomoea batatas (L.) Lam.)
Authors: Wu Zhengdan , Wang Zhiqian , Zhang Kai
Published: December 2021

Sweet potato (Ipomoea batatas (L.) Lam.) is a good source of carbohydrates, an excellent raw material for starch-based industries, and a strong candidate for biofuel production due to its high starch content. However, the molecular basis of starch biosynthesis and accumulation in sweet potato is still insufficiently understood. Glucose-6-phosphate/phosphate translocators (GPTs) mediate the import of glucose-6-phosphate (Glc6P) into plastids for starch synthesis. Here, we report the isolation of a GPT-encoding gene, IbG6PPT1, from sweet potato and the identification of two additional IbG6PPT1 gene copies in the sweet potato genome. IbG6PPT1 encodes a chloroplast membrane–localized GPT belonging to the GPT1 group and highly expressed in storage root of sweet potato. Heterologous expression of IbG6PPT1 resulted in increased starch content in the leaves, root tips, and seeds and soluble sugar in seeds of Arabidopsis thaliana, but a reduction in soluble sugar in the leaves. These findings suggested that IbG6PPT1 might play a critical role in the distribution of carbon sources in source and sink and the accumulation of carbohydrates in storage tissues and would be a good candidate gene for controlling critical starch properties in sweet potato.
A prospective observational real world feasibility study assessing the role of app-based remote patient monitoring in reducing primary care clinician workload during the COVID pandemic
Authors: Shah Sachin Shailendra , Safa Afsana , Johal Kuldhir , Obika Dillon , Valentine Sophie
Published: December 2021

Background

The novel coronavirus disease in 2019 (COVID-19) has placed unprecedented strain on healthcare providers, in particular, primary care services. General practitioners (GP) have to effectively manage patients remotely preserving social distancing. We aim to assess an app-based remote patient monitoring solution in reducing the workload of a clinician and reflect this as time-saved in an economic context. Primary care COVID patients in West London deemed medium risk were recruited into the virtual ward. Patients were monitored for 14 days by telephone or by both the Huma app and telephone. Information on number of phone calls, duration of phone calls and duration of time spent reviewing the app data was recorded.

Results

The amount of time spent reviewing one patient in the telephone only arm of the study was 490 min, compared with 280 min spent reviewing one patient who was monitored via both the Huma app and telephone. Based on employed clinicians monitoring patients, this equates to a 0.04 reduction of full-time equivalent staffing I.e. for every 100 patients, it would require 4 less personnel to remotely monitor them. There was no difference in mortality or adverse events between the two groups.

Conclusion

App-based remote patient monitoring potentially holds large economic benefit to COVID-19 patients. In wake of further waves or future pandemics, and even in routine care, app-based remote monitoring patients could free up vital resources in terms of clinical team’s time, allowing a better reallocation of services.
Over-the-scope clip-assisted endoscopic full-thickness resection has potential to treat complex nonampullary duodenal lesions: a single-center case series
Authors: Wei Yongqiu , Zhou Qiaozhi , Ji Ming , Zhang Shutian , Li Peng
Published: December 2021

Background and aims

The duodenum is considered a challenging area for the endoscopic resection of lesions. This study aimed to evaluate the efficacy and safety of over-the-scope clip (OTSC)-assisted endoscopic full-thickness resection (EFTR) for complex nonampullary duodenal lesions unsuitable for conventional resection techniques.

Methods and patients

We conducted a retrospective case review of 13 consecutive patients with complex nonampullary duodenal tumors that were unsuitable for conventional resection techniques; these patients underwent EFTR assisted with OTSC at Beijing Friendship Hospital, Capital Medical University from September 2015 to September 2020. The OTSC device was placed, and tumors were resected after the lesions were identified. Data were abstracted for demographics, lesion features, histopathologic diagnoses, technical success rates, complete resection (R0 resection) rates, and complications.

Results

Thirteen patients with duodenal lesions (6 adenomas and 7 submucosal tumors with nonlifting signs, incomplete lifting signs, difficult locations, failed ESD/EMR attempts or suspected origin in the muscularis propria) subjected to EFTR were included. The sizes of all the lesions evaluated by endoscopy were smaller than 20 mm, and most of them (84.6%, 11/13) were smaller than 12 mm. All 13 applications of the clips, endoscopic resection and full-thickness resection were successful (13/13, 100%). Complete resection was achieved in 12 patients (12/13, 92.3%). There were no immediate or delayed complications, including bleeding, infection and perforation.

Conclusions

OTSC -assisted EFTR appears to be effective and safe for complex nonampullary duodenal lesions smaller than 20 mm (particularly those ≤ 10–12 mm) that are unsuitable for conventional resection techniques.
A qualitative exploration of the impact of COVID-19 on food decisions of economically disadvantaged families in Northern Ireland
Authors: Spyreli Eleni , McKinley Michelle C. , Woodside Jayne V. , Kelly Colette
Published: December 2021

Background

The first UK-wide lockdown to prevent the spread of COVID-19 had a serious financial impact on low-income households, a population already in higher risk of food insecurity and poor dietary choices. Qualitative data on the impact of COVID-19 lockdown on food decisions of UK families are scarce. This study aimed to explore how the measures to control the spread of COVID-19 influenced the food-related decisions of socioeconomically deprived families in Northern Ireland.

Methods

A qualitative study captured data from online individual interviews. Participation was open for parents of children 2–17 years old living on a tight budget in urban and rural areas of Northern Ireland. A sampling matrix enabled equal representation of single- and two-parent households, as well as parents of younger children (<12y) and adolescents (≥12y). Data were collected by using the methods of Photovoice and mapping exercise. Data were analysed through a thematic approach.

Results

Twelve online interviews were conducted and five distinct themes were identified reflecting families’ food-related decisions that were affected by the COVID-19 lockdown: 1) food planning; 2) food purchasing; 3) meal preparation; 4) eating and feeding behaviours and 5) eating food prepared outside the house.

Conclusions

The restrictions put in place to inhibit the spread of COVID-19 influenced all aspects of dietary decisions of low-income families. Changes observed during this period included frequent consumption of homemade meals, but also increased unhealthy snacking. Infrequent food shopping encouraged good meal planning, but was also a barrier to securing adequate fresh food. Food-related support including school meal assistance contributed to families’ food security, particularly those of single parents.
The impact of high-risk medications on mortality risk among older adults with polypharmacy: evidence from the English Longitudinal Study of Ageing
Authors: Huang Yun-Ting , Steptoe Andrew , Wei Li , Zaninotto Paola
Published: December 2021

Background

Polypharmacy is common among older people and is associated with an increased mortality risk. However, little is known about whether the mortality risk is related to specific medications among older adults with polypharmacy. This study therefore aimed to investigate associations between high-risk medications and all-cause and cause-specific mortality among older adults with polypharmacy.

Methods

This study included 1356 older adults with polypharmacy (5+ long-term medications a day for conditions or symptoms) from Wave 6 (2012/2013) of the English Longitudinal Study of Ageing. First, using the agglomerative hierarchical clustering method, participants were grouped according to the use of 14 high-risk medication categories. Next, the relationship between the high-risk medication patterns and all-cause and cause-specific mortality (followed up to April 2018) was examined. All-cause mortality was assessed by Cox proportional hazards model and competing-risk regression was employed for cause-specific mortality.

Results

Five high-risk medication patterns—a renin-angiotensin-aldosterone system (RAAS) inhibitors cluster, a mental health drugs cluster, a central nervous system (CNS) drugs cluster, a RAAS inhibitors and antithrombotics cluster, and an antithrombotics cluster—were identified. The mental health drugs cluster showed increased risks of all-cause (HR = 1.55, 95%CI = 1.05, 2.28) and cardiovascular disease (CVD) (SHR = 2.11, 95%CI = 1.10, 4.05) mortality compared with the CNS drug cluster over 6 years, while others showed no differences in mortality. Among these patterns, the mental health drugs cluster showed the highest prevalence of antidepressants (64.1%), benzodiazepines (10.4%), antipsychotics (2.4%), antimanic agents (0.7%), opioids (33.2%), and muscle relaxants (21.5%). The findings suggested that older adults with polypharmacy who took mental health drugs (primarily antidepressants), opioids, and muscle relaxants were at higher risk of all-cause and CVD mortality, compared with those who did not take these types of medications.

Conclusions

This study supports the inclusion of opioids in the current guidance on structured medication reviews, but it also suggests that older adults with polypharmacy who take psychotropic medications and muscle relaxants are prone to adverse outcomes and therefore may need more attention. The reinforcement of structured medication reviews would contribute to early intervention in medication use which may consequently reduce medication-related problems and bring clinical benefits to older adults with polypharmacy.
Association of three micro-RNA gene polymorphisms with the risk of cervical cancer: a meta-analysis and systematic review
Authors: Xu Jingyu , Geng Junze , Zhang Qiang , Fan Yihua , Qi Zijun , Xia Tian
Published: December 2021

Objective

Regulation of single nucleotide polymorphisms (SNP) in micro-RNA (miRNA) on the host cells may be one of the most important factors influencing the occurrence of cervical cancer based on the prevalence of HPV infection and the development of cervical cancer. In order to explore the contribution of miRNA polymorphism to the occurrence and development of cervical cancer, we conducted an analytical study.

Methods

We selected the polymorphisms of three widely studied miRNAs (miRNA-146a rs2910164, miRNA-499 rs3746444, and miRNA-196a2 rs11614913). Then, we conducted a meta-analysis (for the first time) to investigate their susceptibility to cervical cancer. Case control studies on the correlation between these three miRNAs and cervical cancer susceptibility were investigated by searching on from Pubmed, The Cochrane Library, Embase, CBM, CNKI, Wanfang database, and VIP database. Basic characteristics were recorded and meta-analysis of the case studies was performed using the STATA 15.1 software.

Results

The miRNA-146a rs2910164 mutation significantly reduced the risk of cervical cancer in both recessive model (OR = 0.804, 95% CI = 0.652-0.992, P = 0.042; CC vs. CG+GG) and allelic model (OR = 0.845, 95% CI = 0.721-0.991, P = 0.038; C vs. G). There was no significant correlation between miRNA-499 rs3746444 and the risk of cervical cancer. The miRNA-196a2 rs11614913 mutation was significantly associated with a reduced risk of cervical cancer in homozygous model (OR = 0.641, 95% CI = 0.447-0.919, P = 0.016; TT vs. CC), dominant model (OR = 0.795, 95% CI = 0.636-0.994, P = 0.045; CT+TT vs. CC), recessive model (OR = 0.698, 95% CI = 0.532-0.917, P = 0.01; TT vs. CC+CT), and allelic models (OR = 0.783, 95% CI = 0.643-0.954, P = 0.015, T vs. C).

Conclusion

In summary, this meta-analysis shows that the mutant genotypes of miRNA-146a rs2910164 and miRNA-196a2 rs11614913 are associated with a reduced risk of cervical cancer. Therefore, they may be two gene regulatory points for the prevention of cervical cancer.

Systematic review registration

PROSPERO registration number CRD42021270079.
Anaclitic-sociotropic and introjective-autonomic personality dimensions and depressive symptoms: a systematic review
Authors: Marfoli Angelica , Viglia Federica , Di Consiglio Micaela , Merola Sheila , Sdoia Stefano , Couyoumdjian Alessandro
Published: December 2021

Sociotropy (anaclitic) and autonomy (introjective) are conceptualised as two personality dimensions that confer vulnerability to depression. According to Blatt and Beck’s theories, sociotropic individuals exhibit distinctive patterns of symptoms such as prominent anxiety, depressed mood, helplessness, crying and somatic concerns, while self-critical ones seem to exhibit a pattern of symptoms including prominent guilt, hopelessness, feelings of failure and worthlessness and other cognitive symptoms.

This systematic review was performed with the aim of investigating whether and to what extent psychological dimensions of anaclitic-sociotropic and introjective-autonomy are related to a specific core of depressive symptoms. The search was conducted in three databases (PubMed, PsycINFO and Scopus) and 27 articles were selected.

Results showed a weak association between somatic symptoms and dependent personality traits, while the relationship between self-criticism and cognitive symptomatology was significantly higher. These findings are discussed in the context of future research, necessary to corroborate the existence of a form of depression characterised by somatic features usually ignored by diagnostic criteria, essential to direct psychological treatments to these depressive personality differences.
A case of catatonia in the aftermath of the COVID-19 pandemic: does autism spectrum matter?
Authors: Dell’Osso Liliana , Amatori Giulia , Gesi Camilla , Carmassi Claudia
Published: December 2021

Background

There is growing concern about the psychopathological consequences of the COVID-19 pandemic. The prolonged stress due to the spreading fear of the contagion and to the enforced containment measures are deemed to trigger recurrences of preexisting mental disorders as well as the onset of new ones. From such perspective, clinical cases may be of primary ground to identify individual features and pandemic-related factors predisposing to the development of serious psychiatric symptoms.

Case presentation

Mr. R. is a 64-year-old, married, unemployed man, whose premorbid personality was characterized by relevant autistic traits. The patient developed catatonia in the context of the COVID-19 pandemic. We aimed at discussing the role of both preexisting and precipitating factors.

Conclusions

Autism spectrum could represent a predisposing factor for severe psychopathological outcome and catatonia. Furthermore, the present clinical case highlights the role of COVID-19 pandemic in influencing physical and mental health.
Persisting neuroendocrine abnormalities and their association with physical impairment 5 years after critical illness
Authors: Vanhorebeek Ilse , Derese Inge , Gunst Jan , Wouters Pieter J. , Hermans Greet , Van den Berghe Greet
Published: December 2021

Background

Critical illness is hallmarked by neuroendocrine alterations throughout ICU stay. We investigated whether the neuroendocrine axes recover after ICU discharge and whether any residual abnormalities associate with physical functional impairments assessed 5 years after critical illness.

Methods

In this preplanned secondary analysis of the EPaNIC randomized controlled trial, we compared serum concentrations of hormones and binding proteins of the thyroid axis, the somatotropic axis and the adrenal axis in 436 adult patients who participated in the prospective 5-year clinical follow-up and who provided a blood sample with those in 50 demographically matched controls. We investigated independent associations between any long-term hormonal abnormalities and physical functional impairments (handgrip strength, 6-min walk distance, and physical health-related quality-of-life) with use of multivariable linear regression analyses.

Results

At 5-year follow-up, patients and controls had comparable serum concentrations of thyroid-stimulating hormone, thyroxine (T4), triiodothyronine (T3) and thyroxine-binding globulin, whereas patients had higher reverse T3 (rT3, p = 0.0002) and lower T3/rT3 (p = 0.0012) than controls. Patients had comparable concentrations of growth hormone, insulin-like growth factor-I (IGF-I) and IGF-binding protein 1 (IGFBP1), but higher IGFBP3 (p = 0.030) than controls. Total and free cortisol, cortisol-binding globulin and albumin concentrations were comparable for patients and controls. A lower T3/rT3 was independently associated with lower handgrip strength and shorter 6-min walk distance (p ≤ 0.036), and a higher IGFBP3 was independently associated with higher handgrip strength (p = 0.031).

Conclusions

Five years after ICU admission, most hormones and binding proteins of the thyroid, somatotropic and adrenal axes had recovered. The residual long-term abnormality within the thyroid axis was identified as risk factor for long-term physical impairment, whereas that within the somatotropic axis may be a compensatory protective response. Whether targeting of the residual abnormality in the thyroid axis may improve long-term physical outcome of the patients remains to be investigated.

Trial registration ClinicalTrials.gov: NCT00512122, registered on July 31, 2007 (https://www.clinicaltrials.gov/ct2/show/NCT00512122).

Graphical Abstract
Update to the study protocol for an implementation-effectiveness trial comparing two education strategies for improving the uptake of noninvasive ventilation in patients with severe COPD exacerbation
Authors: Stefan Mihaela S. , Pekow Penelope S. , Shea Christopher M. , Hughes Ashley M. , Hill Nicholas S. , Steingrub Jay S. , Farmer Mary Jo S. , Hess Dean R. , Riska Karen L. , Clark Taylar A. , Lindenauer Peter K.
Published: December 2021

Background

There is strong evidence that noninvasive ventilation (NIV) improves the outcomes of patients hospitalized with severe COPD exacerbation, and NIV is recommended as the first-line therapy for these patients. Yet, several studies have demonstrated substantial variation in NIV use across hospitals, leading to preventable morbidity and mortality. In addition, prior studies suggested that efforts to increase NIV use in COPD need to account for the complex and interdisciplinary nature of NIV delivery and the need for team coordination. Therefore, our initial project aimed to compare two educational strategies: online education (OLE) and interprofessional education (IPE), which targets complex team-based care in NIV delivery. Due to the impact of the COVID-19 pandemic on recruitment and planned intervention, we had made several changes in the study design, statistical analysis, and implementation strategies delivery as outlined in the methods.

Methods

We originally proposed a two-arm, pragmatic, cluster, randomized hybrid implementation-effectiveness trial comparing two education strategies to improve NIV uptake in patients with severe COPD exacerbation in 20 hospitals with a low baseline rate of NIV use. Due to logistical constrains and slow recruitment, we changed the study design to an opened cohort stepped-wedge design with three steps which will allow the institutions to enroll when they are ready to participate. Only the IPE strategy will be implemented, and the education will be provided in an online virtual format. Our primary outcome will be the hospital-level risk-standardized NIV proportion for the period post-IPE training, along with the change in rate from the period prior to training. Aim 1 will compare the change over time of NIV use among patients with COPD in the step-wedged design. Aim 2 will explore the mediators’ role (respiratory therapist autonomy and team functionality) on the relationship between the implementation strategies and effectiveness. Finally, in Aim 3, through interviews with providers, we will assess the acceptability and feasibility of the educational training.

Conclusion

The changes in study design will result in several limitation. Most importantly, the hospitals in the three cohorts are not randomized as they enroll based on their readiness. Second, the delivery of the IPE is virtual, and it is not known if remote education is conducive to team building. However, this study will be among the first to test the impact of IPE in the inpatient setting carefully and may generalize to other interventions directed to seriously ill patients.

Trial registration

ClinicalTrials.govNCT04206735. Registered on December 20, 2019;
Using the co-expression network of T cell-activation-related genes to assess the disease activity in Takayasu’s arteritis patients
Authors: Tian Yixiao , Li Jing , Tian Xinping , Zeng Xiaofeng
Published: December 2021

Background

There have been lacking reliable serum biomarkers in assessing the disease activity of Takayasu’s arteritis (TAK). This study aimed to assess the disease activity of TAK by assayed gene expression levels in peripheral mononuclear cells (PBMCs).

Methods

The expression level of genes that essential in T cell activation in PBMCs in active TAK patients, inactive TAK patients, and healthy controls were detected by real-time fluorescence quantitative polymerase chain reaction, including TCR, CD28, CD40, CD40L, PD-1, PD-L1, PD-L2, CTLA4, TIGIT, TIM3, LAG3, CCL5, T-bet, RORC, and FOXP3. Gene co-expression network was established, and the signature of the topology structure in active TAK patients compared to the inactive TAK patients were extracted and described by formulas. Respectively, the disease activity was assessed by the routine serum biomarkers, including ESR, CRP, IL-6, and TNF-α, the gene expression level of TCR, CD28, T-bet, and RORC, as well as the signature of the topology structure, and the diagnostic efficacies were compared.

Results

Compared with the inactive TAK patient group, the active TAK patient group had a greater clustering coefficient in the network consisting of genes that essential in T cell activation. When assessing the disease activity used this signature of topology structure, the sensitivity was 90.9%, the specificity was 100%, and the AUC was 0.98, which was greater than the AUCs of these biomarkers.

Conclusions

The signature of the topology structure could distinguish the active TAK patients from inactive TAK patients. This maybe is a novel evaluation algorithm of disease activity.
French Bulldogs differ to other dogs in the UK in propensity for many common disorders: a VetCompass study
Authors: O’Neill Dan G. , Packer Rowena M.A. , Francis Peter , Church David B. , Brodbelt Dave C. , Pegram Camilla
Published: December 2021

Background

The French Bulldog is a highly popular dog breed but is linked with many serious health issues. A holistic view of breed health in French Bulldogs would assist efforts to appreciate the overall health strengths and weaknesses in the French Bulldog and to take appropriate steps to mitigate these.

Based on random sampling of French Bulldogs and non-French Bulldogs under primary veterinary care during 2016 within the VetCompass Programme, a cohort study design was used to estimate the one-year (2016) period prevalence of the most commonly diagnosed disorders in each group. Risk factor analysis used multivariable logistic regression modelling methods.

Results

The analysis included 2,781 French Bulldogs and 21,850 non-French Bulldogs. French Bulldogs were younger (1.51 years, IQR 0.86 – 2.77 vs. 4.48 years, IQR 1.94 – 8.14) (p < 0.001) and lighter (12.45 kg, IQR 11.00 – 14.03 versus 13.80 kg, IQR 8.10 – 25.12) (p < 0.001) than non-French Bulldogs. Of 43 common specific-level disorders across both groups, French Bulldogs had significantly increased adjusted odds of 20/43 (46.5 %) disorders and significantly reduced adjusted odds of 11/43 (25.6 %) disorders compared to non-French Bulldogs. Highly predisposed disorders in French Bulldogs included stenotic nares (OR 42.14; 95 % CI 18.50 to 95.99; p < 0.001), Brachycephalic Obstructive Airway Syndrome (OR 30.89; 95 % CI 20.91 to 45.64; p < 0.001), aural discharge (OR 14.40; 95 % CI 9.08 to 22.86; p < 0.001), skin fold dermatitis (OR 11.18; 95 % CI 7.19 to 17.40; p < 0.001) and dystocia (OR 9.13; 95 % CI 5.17 to 16.13; p < 0.001). At a grouped-level of diagnostic precision, French Bulldogs had increased adjusted odds of 12/32 (37.5 %) disorders and reduced adjusted odds of 6/32 (18.8 %) disorders compared to non-French Bulldogs.

Conclusions

These results identified ultra-predispositions with worryingly higher odds in French Bulldogs for several disorders, suggesting that the health of French Bulldogs has diverged substantially from, and may be lower than, the health of the wider non-French Bulldog population. Many of these predispositions are closely associated with the conformational extremes that define the French Bulldog breed. Shifting the typical conformation of the French Bulldog population towards a more moderate phenotype is proposed as a logical opportunity to reduce the serious health issues endemic in the French Bulldog breed.
Modelling of geomagnetically induced currents in the Czech transmission grid
Authors: Švanda Michal , Smičková Anna , Výbošťoková Tatiana
Published: December 2021

We investigate the maximum expected magnitudes of the geomagnetically induced currents (GICs) in the Czech transmission power network. We compute a model utilising the Lehtinen–Pirjola method, considering the plane-wave model of the geoelectric field, and using the transmission network parameters kindly provided by the operator. We find that the maximum amplitudes expected in the nodes of the Czech transmission grid during the Halloween storm-like event are about 15 A. For the “extreme-storm” conditions with a 1-V/km geoelectric field, the expected maxima do not exceed 40 A. We speculate that the recently proven statistical correlation between the increased geomagnetic activity and anomaly rate in the power grid may be due to the repeated exposure of the devices to the low-amplitude GICs.

Graphical Abstract
Schools as spaces for in/exclusion of young Mainland Chinese students and families in Hong Kong
Authors: Leung Maggi W. H. , Waters Johanna L. , Ki Yutin
Published: December 2021

Around 30,000 children living in Shenzhen, Mainland China cross the border to Hong Kong to attend school every day. This paper focuses on the school as a key meso-level organisation that mediates macro-level policies and micro-level everyday life experiences among these children and their families. We advocate a relational, spatial perspective, conceptualising schools as webs of intersecting physical, social and digital spaces, where differences between the “locals” and “others” are played out, negotiated and (re)produced, and in turn giving rise to specific (and understudied) geographies of in/exclusion. Drawing on our qualitative research, we offer a close reading of three exemplary school spaces: (i) the physical classroom and school grounds, (ii) the digital classroom, and (iii) at the school gate. Our findings demonstrate the complex and at times contradictory ways in which “the school” is a place of both inclusion and exclusion. It is a dynamic and power-traversed space where social differences between the “locals” and the “others” are played out, contested and redefined continuously.