bluuebunny/crossref_metadata_2025 huggingface dataset:
Initial Maximum Push-Rim Propulsion and Sprint Performance in Elite Women’s Wheelchair Basketball: Differences Between Players’ Functional Classification
Authors: García-Fresneda Adrián , Carmona Gerard , Yanci Javier , Iturricastillo Aitor
Published: June 2022

The aim of the present study was to determine, for the first time in elite women’s wheelchair basketball, the differences in the initial maximum push-rim propulsion (IMPRP), mechanical outputs, and sprint performance between A category (≤2.5 class) and B category (≥3 class) players. A secondary aim was to assess the association between IMPRP mechanical outputs and sprint performance to determine the influence of specific strength in the latter. Sixteen Spanish women’s wheelchair basketball players participated in this study: A category (n = 9, International Wheelchair Basketball Federation [IWBF] classification range: 1–2.5 points) and B category (n = 7, IWBF classification range: 3–4.5 points). All the players undertook 2 tests: the IMPRP test to measure the strength variables and the 3-, 5-, and 12-m sprint test. B category players reported significantly better performance values in almost all the IMPRP variables and all the sprint distances than A category players. Large to very large significant correlations were observed among IMPRP absolute mechanical outputs (excepting mean power) and sprint performance (3, 5, and 12 m) for all the participants. When the group was divided according to categories A and B, the significant differences observed in the whole group decreased in both groups, although some relationships were large or very large. The IMPRP test and sprint test (3, 5, and 12 m) seemed to be sensitive to differentiate the level between the 2 functional categories. In addition, there was a high association between strength and sprint variables, which shows that greater strength could improve sprint capacity.
Divergent cis-regulatory evolution underlies the convergent loss of sodium channel expression in electric fish
Authors: LaPotin Sarah , Swartz Mary E. , Luecke David M. , Constantinou Savvas J. , Gallant Jason R. , Eberhart Johann K. , Zakon Harold H.
Published: June 2022

South American and African weakly electric fish independently evolved electric organs from muscle. In both groups, a voltage-gated sodium channel gene independently lost expression from muscle and gained it in the electric organ, allowing the channel to become specialized for generating electric signals. It is unknown how this voltage-gated sodium channel gene is targeted to muscle in any vertebrate. We describe an enhancer that selectively targets sodium channel expression to muscle. Next, we demonstrate how the loss of this enhancer, but not trans-activating factors, drove the loss of sodium channel gene expression from muscle in South American electric fish. While this enhancer is also altered in African electric fish, key transcription factor binding sites and enhancer activity are retained, suggesting that the convergent loss of sodium channel expression from muscle in these two electric fish lineages occurred via different processes.
Archean cratonic mantle recycled at a mid-ocean ridge
Authors: Liu Chuan-Zhou , Dick Henry J.B. , Mitchell Ross N. , Wei Wu , Zhang Zhen-Yu , Hofmann Albrecht W. , Yang Jian-Feng , Li Yang
Published: June 2022

Basalts and mantle peridotites of mid-ocean ridges are thought to sample Earth’s upper mantle. Osmium isotopes of abyssal peridotites uniquely preserve melt extraction events throughout Earth history, but existing records only indicate ages up to ~2 billion years (Ga) ago. Thus, the memory of the suspected large volumes of mantle lithosphere that existed in Archean time (>2.5 Ga) has apparently been lost somehow. We report abyssal peridotites with melt-depletion ages up to 2.8 Ga, documented by extremely unradiogenic
187
Os/
188
Os ratios (to as low as 0.1095) and refractory major elements that compositionally resemble the deep keels of Archean cratons. These oceanic rocks were thus derived from the once-extensive Archean continental keels that have been dislodged and recycled back into the mantle, the feasibility of which we confirm with numerical modeling. This unexpected connection between young oceanic and ancient continental lithosphere indicates an underappreciated degree of compositional recycling over time.
Electronic quantum coherence in glycine molecules probed with ultrashort x-ray pulses in real time
Authors: Schwickert David , Ruberti Marco , Kolorenč Přemysl , Usenko Sergey , Przystawik Andreas , Baev Karolin , Baev Ivan , Braune Markus , Bocklage Lars , Czwalinna Marie Kristin , Deinert Sascha , Düsterer Stefan , Hans Andreas , Hartmann Gregor , Haunhorst Christian , Kuhlmann Marion , Palutke Steffen , Röhlsberger Ralf , Rönsch-Schulenburg Juliane , Schmidt Philipp , Toleikis Sven , Viefhaus Jens , Martins Michael , Knie André , Kip Detlef , Averbukh Vitali , Marangos Jon P. , Laarmann Tim
Published: June 2022

Here, we use x-rays to create and probe quantum coherence in the photoionized amino acid glycine. The outgoing photoelectron leaves behind the cation in a coherent superposition of quantum mechanical eigenstates. Delayed x-ray pulses track the induced coherence through resonant x-ray absorption that induces Auger decay and by photoelectron emission from sequential double photoionization. Sinusoidal temporal modulation of the detected signal at early times (0 to 25 fs) is observed in both measurements. Advanced ab initio many-electron simulations allow us to explain the first 25 fs of the detected coherent quantum evolution in terms of the electronic coherence. In the kinematically complete x-ray absorption measurement, we monitor its dynamics for a period of 175 fs and observe an evolving modulation that may implicate the coupling of electronic to vibronic coherence at longer time scales. Our experiment provides a direct support for the existence of long-lived electronic coherence in photoionized biomolecules.
Printed synaptic transistor–based electronic skin for robots to feel and learn
Authors: Liu Fengyuan , Deswal Sweety , Christou Adamos , Shojaei Baghini Mahdieh , Chirila Radu , Shakthivel Dhayalan , Chakraborty Moupali , Dahiya Ravinder
Published: June 2022

An electronic skin (e-skin) for the next generation of robots is expected to have biological skin-like multimodal sensing, signal encoding, and preprocessing. To this end, it is imperative to have high-quality, uniformly responding electronic devices distributed over large areas and capable of delivering synaptic behavior with long- and short-term memory. Here, we present an approach to realize synaptic transistors (12-by-14 array) using ZnO nanowires printed on flexible substrate with 100% yield and high uniformity. The presented devices show synaptic behavior under pulse stimuli, exhibiting excitatory (inhibitory) post-synaptic current, spiking rate-dependent plasticity, and short-term to long-term memory transition. The as-realized transistors demonstrate excellent bio-like synaptic behavior and show great potential for in-hardware learning. This is demonstrated through a prototype computational e-skin, comprising event-driven sensors, synaptic transistors, and spiking neurons that bestow biological skin-like haptic sensations to a robotic hand. With associative learning, the presented computational e-skin could gradually acquire a human body–like pain reflex. The learnt behavior could be strengthened through practice. Such a peripheral nervous system–like localized learning could substantially reduce the data latency and decrease the cognitive load on the robotic platform.
Kinetic Characterization of the Immune Response to Methicillin-Resistant Staphylococcus aureus Subcutaneous Skin Infection
Authors: Ridder Miranda J. , McReynolds Aubrey K.G. , Dai Hongyan , Pritchard Michele T. , Markiewicz Mary A. , Bose Jeffrey L.
Published: June 2022

Staphylococcus aureusis a leading cause of skin and soft tissue infections (SSTIs). Studies examining the immune response toS. aureushave been conducted, yet our understanding of the kinetic response toS. aureussubcutaneous skin infection remains incomplete.
Development of a Rapid Live SARS-CoV-2 Neutralization Assay Based on a qPCR Readout
Authors: Lichtenegger Sabine , Saiger Sabine , Hardt Melina , Kulnik Susanne , Wagner Gabriel E. , Kleinhappl Barbara , Assig Karoline , Zauner Andrea , Ober Michelle , Kimpel Janine , von Laer Dorothee , Zatloukal Kurt , Steinmetz Ivo
Published: June 2022

Measuring SARS-CoV-2 neutralizing antibodies after vaccination or natural infection remains a priority in the ongoing COVID-19 pandemic to determine immunity, especially against newly emerging variants. The gold standard for assessing antibody-mediated immunity against SARS-CoV-2 are cell-based live virus neutralization assays.
Biological Microbial Interactions from Cooccurrence Networks in a High Mountain Lacustrine District
Authors: Ontiveros Vicente J. , Ortiz-Álvarez Rüdiger , Capitán José A. , Barberán Albert , Alonso David , Casamayor Emilio O.
Published: June 2022

A fundamental question in biology is why some species tend to occur together in the same locations, while others are never observed to coexist. This question becomes particularly relevant for microorganisms thriving in the highly diluted waters of high mountain lakes, in which biotic interactions might be required to make the most of an extreme environment.
Sepsis-Induced Gut Dysbiosis Mediates the Susceptibility to Sepsis-Associated Encephalopathy in Mice
Authors: Fang Heng , Wang Yirong , Deng Jia , Zhang Huidan , Wu Qingrui , He Linling , Xu Jing , Shao Xin , Ouyang Xin , He Zhimei , Zhou Qiuping , Wang Huifang , Deng Yiyu , Chen Chunbo
Published: June 2022

The bidirectional interactions between the gut microbiota and sepsis-associated encephalopathy (SAE) are not well characterized. We found that the gut microbiota was more severely disturbed in SAE-susceptible (SES) mice than in SAE-resistant (SER) mice after sepsis modeling.
Phylogenomic Analysis of Metagenome-Assembled Genomes Deciphered Novel Acetogenic Nitrogen-Fixing
Bathyarchaeota
from Hot Spring Sediments
Authors: Deb Sushanta , Das Subrata K.
Published: June 2022

We describe the
Bathyarchaeota
bins that are likely to be acetogens with a wide range of metabolic potential. These bins did not exhibit methanogenic machinery, suggesting methane production may not occur by all subgroup lineages of
Bathyarchaeota
. Phylogenetic analysis support that both ILS200 and ILS300 belonged to the
Bathyarchaeota
. The discovery of new bathyarchaeotal MAGs provides additional knowledge for understanding global carbon and nitrogen metabolism under extreme conditions.
Compartmentalized into Bacteriocytes but Highly Invasive: the Puzzling Case of the Co-Obligate Symbiont Serratia symbiotica in the Aphid
Periphyllus lyropictus
Authors: Renoz François , Lopes Mélanie Ribeiro , Gaget Karen , Duport Gabrielle , Eloy Marie-Christine , Geelhand de Merxem Benoît , Hance Thierry , Calevro Federica
Published: June 2022

Multipartner nutritional endosymbioses have evolved many times in insects. In Chaitophorinae aphids, the eroded metabolic capabilities of the ancient obligate symbiont
B. aphidicola
are complemented by those of more recently acquired symbionts.
Genome of Malassezia arunalokei and Its Distribution on Facial Skin
Authors: Cho Yong-Joon , Kim Taeyune , Croll Daniel , Park Minji , Kim Donghyeun , Keum Hye Lim , Sul Woo Jun , Jung Won Hee
Published: June 2022

Malassezia
is the fungus predominantly residing on the human skin and causes various skin diseases, including seborrheic dermatitis and dandruff. To date, 18 species have been reported, and among them,
M. restricta
is the most predominant on human skin, especially on the scalp.
Coexistence of
tmexCD-toprJ
,
bla
NDM-1
, and
bla
IMP-4
in One Plasmid Carried by Clinical
Klebsiella
spp.
Authors: Xiao Tao , Peng Kai , Chen Qi , Hou Xueqin , Huang Weifeng , Lv Hong , Yang Xiaorong , Lei Gaopeng , Li Ruichao
Published: June 2022

Tigecycline is an essential antibiotic that is used to treat infections caused by carbapenem-resistant
Klebsiella pneumoniae
(CRKP). The emergence of high-level tigecycline-resistant CRKP poses a serious hazard to human health.
Increase in Bruch’s membrane opening minimum rim width with age in healthy children: the Hong Kong Children Eye Study
Authors: Zhang Xiu Juan , Tang Shu Min , Wang Yu Meng , Zhang Yuzhou , Chan Hei-Nga , Lau Yi Han , Kam Ka Wai , Chan Poemen P , Ip Patrick , Young Alvin L , Tham Clement C , Chen Li Jia , Pang Chi Pui , Yam Jason C
Published: June 2022

Background/aims

To identify normative values and determinants for Bruch’s membrane opening (BMO) and the minimum rim width of BMO (BMO-MRW) among healthy children.

Methods

A population-based cross-sectional study from the Hong Kong Children Eye Study, recruiting 1, 226 children aged 6–8 years. Spherical refractive error, axial length (AL), body mass index and intraocular pressure (IOP) were measured. The optic nerve head and the peripapillary retinal nerve fibre layer (p-RNFL) were imaged through spectral domain-optical coherence tomography, using 24 equally spaced radial B-scans. Global and sectoral BMO-MRW values, BMO area and fovea-to-BMO (FoBMO) angle were calculated. Multiple regression analysis was performed to define the determinants of BMO area and BMO-MRW in relation to demographic and ocular parameters.

Results

The mean values for global BMO-MRW, BMO area and FoBMO angle among children were 345.76±54.08 µm, 2.34±0.49 mm2and −5.45±4.36°, respectively. Global and sectoral values for BMO-MRW correlated with p-RNFL thickness (r=0.11–0.35, p<0.001). After adjusting for demographic and ocular parameters, global BMO-MRW increased with age (β=6.4, p<0.001) and greater global p-RNFL thickness (β=1.41, p<0.001), but decreased with larger BMO area (β=−47.46, p<0.001) and higher IOP (β=−1.73, p<0.001). Global BMO-MRW did not associate with AL, whereas both BMO area and FoBMO angle associated with AL (β=0.04, p=0.02 and β=0.31, p=0.03, respectively), but not with age.

Conclusion

We observed that BMO-MRW increases with age among children. Our results provide normative values and the determinants of BMO parameters among Chinese children.
Short-term effectiveness of high-load compared with low-load strengthening exercise on self-reported function in patients with hypermobile shoulders: a randomised controlled trial
Authors: Liaghat Behnam , Skou Søren T , Søndergaard Jens , Boyle Eleanor , Søgaard Karen , Juul-Kristensen Birgit
Published: June 2022

Objectives

To investigate the short-term effectiveness of high-load versus low-load strengthening exercise on self-reported function in patients with hypermobility spectrum disorder (HSD) and shoulder symptoms.

Methods

A superiority, parallel-group, randomised trial (balanced block randomisation, electronic concealment) including adult patients (n=100) from primary care with HSD and shoulder pain and/or shoulder instability ≥3 months. Patients received 16 weeks of shoulder exercises (three sessions/week): HEAVY (n=50, full-range, high-load, supervised twice/week) or LIGHT (n=50, neutral/mid-range, low-load, supervised three times). The primary outcome was the 16-week between-group difference in self-reported function measured with the Western Ontario Shoulder Instability Index (WOSI, scale 0–2100, 0=best, minimal important difference 252 points). Secondary outcomes were self-reported measures including quality of life and clinical tests including shoulder muscle strength and range of motion. An intention-to-treat analysis with multiple imputation was conducted by a blinded biostatistician using linear regression.

Results

93 of 100 patients (93%) completed the 16-week evaluation. The mean WOSI score between-group difference significantly favoured HEAVY (−174.5 points, 95% CI −341.4 to −7.7, adjusted for age, sex, baseline score, clustering around clinic). The secondary outcomes were inconclusive, but patients in HEAVY were less likely to have a positive shoulder rotation test >180°, and more likely to rate an important improvement in physical symptoms. There were no serious adverse events, but HEAVY was associated with more transient muscle soreness (56% vs 37%) and headaches (40% vs 20%).

Conclusion

High-load shoulder strengthening exercise was statistically superior to low-load strengthening exercise for self-reported function at 16 weeks and may be used in primary care to treat patients with HSD and shoulder pain and/or instability to improve shoulder function in the short term. Further studies are needed to confirm the clinical relevance, and patients should be supported to manage associated minor adverse events.

Trial registration number

NCT03869307.
Audio innovation and songs to spur change in global health: evidence from a national crowdsourcing open call for youth social innovation in Malaysia
Authors: Tan Rayner Kay Jin , Mpofu Ralph , Kay Pradheep , Sebastian Darien , Novakovic Djordje , Lo Ying-Ru Jacqueline , Tucker Joseph D
Published: June 2022

Introduction

Audio innovations remain an important medium to drive innovation in health, especially in low-resource settings. This article explores the role of audio innovation to spur change in the context of a crowdsourcing open call for youth (18–30 years old) in Malaysia.

Methods

A crowdsourcing open call for youth in Malaysia was organised from March to June 2021 using standards from the WHO-TDR. The open call was called ‘Imagine the World Anew’ and submission categories included youth-led messaging, youth social innovation and youth strategic planning. We analyse open call submissions and provide a more detailed analysis of an audio submission.

Results

A total 43 entries were submitted to the open call and 6 were selected for grand prizes. One of the two grand prizes in the youth messaging category was a song developed by a youth team. The song was called ‘Rise Up’ and was developed by Malaysian youth to demonstrate how youth have been critical agents for change during the COVID-19 pandemic. The audio format allowed the youth to directly speak to other Malaysian youth, leverage existing audio channels and democratise messaging during COVID-19. Building on the experience from this crowdsourcing open call, we also describe key considerations for open calls to incorporate audio innovations in low-resource settings.

Conclusion

Audio innovations like songs can mobilise youth and other members of the public and amplify their voices. Audio messages may enhance dissemination of health messages in diverse low-income and middle-income country settings.
Acquisition and retention of military surgical competencies: a survey of surgeons’ experiences in the UK Defence Medical Services
Authors: Cant Matthew R , Naumann D N , Swain C , Mountain A J , Baden J , Bowley D M
Published: June 2022

Introduction

The acquisition and retention of militarily relevant surgical knowledge and skills are vital to enable expert management of combat casualties on operations. Opportunities for skill sustainment have reduced due to the cessation of combat operations in Iraq and Afghanistan and lack of military-relevant trauma in UK civilian practice.

Methods

A voluntary, anonymous online survey study was sent to all UK Defence Medical Services (DMS) surgical consultants and higher surgical trainees in Trauma and Orthopaedics, Plastic and Reconstructive, and General and Vascular surgical specialties (three largest surgical specialties in the DMS in terms of numbers). The online questionnaire tool included 20 questions using multiple choice and free text to assess respondents’ subjective feelings of preparedness for deployment as surgeons for trauma patients.

Results

There were 71 of 108 (66%) responses. Sixty-four (90%) respondents were regular armed forces, and 46 (65%) worked in a Major Trauma Centre (MTC). Thirty-three (47%) had never deployed on operations in a surgical role. Nineteen (27%) felt they had sufficient exposure to penetrating trauma. When asked‘How well do you feel your training and clinical practice prepares you for a surgical deployment?’ on a scale of 1–10, trainees scored significantly lower than consultants (6 (IQR 4–7) vs 8 (IQR 7–9), respectively; p<0.001). There was no significant difference in scores between regular and reservists, or between those working at an MTC versus non-MTC. Respondents suggested high-volume trauma training and overseas trauma centre fellowships, simulation, cadaveric and live-tissue training would help their preparedness.

Conclusions

There was a feeling among a sample of UK DMS consultants and trainees that better preparedness is required for them to deploy confidently as a surgeon for combat casualties. The responses suggest that UK DMS surgical training requires urgent attention if current surgeons are to be ready for their role on deployed operations.
Socioeconomic and health-related inequalities in major depressive symptoms among older adults: a Wagstaff’s decomposition analysis of data from the LASI baseline survey, 2017–2018
Authors: Muhammad T. , Skariah Anjali Elsa , Kumar Manish , Srivastava Shobhit
Published: June 2022

Objectives

To find out the association between socioeconomic and health status and depression among older adults and explore the contributing factors in the socioeconomic and health-related inequalities in late-life depression.

Design

A cross-sectional study was conducted using large representative survey data.

Setting and participants

Data for this study were derived from the baseline wave of the Longitudinal Ageing Study in India conducted during 2017–2018. The effective sample size was 30 888 older adults aged 60 years and above.

Primary and secondary outcome measures

The outcome variable in this study was depression among older adults. Descriptive statistics along with bivariate analysis was conducted to report the preliminary results. Multivariable binary logistic regression analysis and Wagstaff’s decomposition were used to fulfil the objectives of the study.

Results

There was a significant difference for the prevalence of depression (4.3%; p<0.05) among older adults from poor (11.2%) and non-poor categories (6.8%). The value of the Concentration Index was −0.179 which also confirms that the major depression was more concentrated among poor older adults. About 38.4% of the socioeconomic and health-related inequality was explained by the wealth quintile for major depression among older adults. Moreover, about 26.6% of the inequality in major depression was explained by psychological distress. Self-rated health (SRH), difficulty in activities of daily living (ADL) and instrumental ADL (IADL) contributed 8.7%, 3.3% and 4.8% to the inequality, respectively. Additionally, region explained about 23.1% of inequality followed by life satisfaction (11.2) and working status (9.8%) for major depression among older adults.

Conclusions

Findings revealed large socioeconomic and health-related inequalities in depression in older adults which were especially pronounced by poor household economy, widowhood, poor SRH, ADL and IADL difficulty, and psychological distress. In designing prevention programmes, detection and management of older adults with depression should be a high priority, especially for those who are more vulnerable.
Web-based mindfulness and skills-based distress reduction for patients with cancer: study protocol of the multicentre, randomised, controlled confirmatory intervention trial Reduct
Authors: Bäuerle Alexander , Martus Peter , Erim Yesim , Schug Caterina , Heinen Jana , Krakowczyk Julia Barbara , Steinbach Jasmin , Damerau Mirjam , Bethge Wolfgang , Dinkel Andreas , Dries Sebastian , Mehnert-Theuerkauf Anja , Neumann Anja , Schadendorf Dirk , Tewes Mitra , Wiltink Jörg , Wünsch Alexander , Zipfel Stephan , Graf Johanna , Teufel Martin
Published: June 2022

Introduction

Many patients with cancer experience severe psychological distress, but as a result of various barriers, few of them receive psycho-oncological support. E-mental health interventions try to overcome some of these barriers and the limitation of healthcare offers, enabling patients with cancer to better cope with psychological distress. In the proposed trial, we aim to assess the efficacy and cost-effectiveness of the manualised e-mental health intervention Make It Training- Mindfulness-Based and Skills-Based Distress Reduction in Oncology. Make It Training is a self-guided and web-based psycho-oncological intervention, which includes elements of cognitive behavioural therapy, mindfulness-based stress reduction and acceptance and commitment therapy. The training supports the patients over a period of 4 months. We expect the Make It Training to be superior to treatment as usual optimised (TAU-O) in terms of reducing distress after completing the intervention (T1, primary endpoint).

Methods and analysis

The study comprises a multicentre, prospective, randomised controlled confirmatory interventional trial with two parallel arms. The proposed trial incorporates four distinct measurement time points: the baseline assessment before randomisation, a post-treatment assessment and 3 and 6 month follow-up assessments. We will include patients who have received a cancer diagnosis in the past 12 months, are in a curative treatment setting, are 18–65 years old, have given informed consent and experience high perceived psychological distress (Hospital Anxiety and Depression Scale ≥13) for at least 1 week. Patients will be randomised into two groups (Make It vs TAU-O). The aim is to allocate 600 patients with cancer and include 556 into the intention to treat analysis. The primary endpoint, distress, will be analysed using a baseline-adjusted ANCOVA for distress measurement once the intervention (T1) has been completed, with study arm as a binary factor, baseline as continuous measurement and study centre as an additional categorical covariate.

Ethics and dissemination

The Ethics Committee of the Medical Faculty Essen has approved the study (21-10076-BO). Results will be published in peer-reviewed journals, conference presentations, the project website, and among self-help organisations.

Trial registration number

German Clinical Trial Register (DRKS); DRKS-ID: DRKS00025213.
Charming e-cigarette users with distorted science: a survey examining social media platform use, nicotine-related misinformation and attitudes towards the tobacco industry
Authors: Silver Nathan A , Kierstead Elexis C , Briggs Jodie , Schillo Barbara
Published: June 2022

Objective

To examine the role of social media in promoting recall and belief of distorted science about nicotine and COVID-19 and whether recall and belief predict tobacco industry beliefs.

Design

Young adults aged 18–34 years (N=1225) were surveyed cross-sectionally via online Qualtrics panel. The survey assessed recall and belief in three claims about nicotine and COVID-19 and three about nicotine in general followed by assessments of industry beliefs and use of social media. Ordinal logistic regression with robust standard errors controlling for gender, race/ethnicity, education, current e-cigarette use and age was used to examine relationships between variables.

Results

Twitter use was associated with higher odds of recall (OR=1.21, 95% CI=1.01 to 1.44) and belief (OR=1.26, 95% CI=1.04 to 1.52) in COVID-19-specific distorted science. YouTube use was associated with higher odds of believing COVID-19-specific distorted science (OR=1.32, 95% CI=1.09 to 1.60). Reddit use was associated with lower odds of believing COVID-19-specific distorted science (OR=0.72, 95% CI=0.59 to 0.88). Recall (OR=1.26, 95% CI=1.07 to 1.47) and belief (OR=1.28, 95% CI=1.09 to 1.50) in distorted science about nicotine in general as well as belief in distorted science specific to COVID-19 (OR=1.61, 95% CI=1.34 to 1.95) were associated with more positive beliefs about the tobacco industry. Belief in distorted science about nicotine in general was also associated with more negative beliefs about the tobacco industry (OR=1.18, 95% CI=1.02 to 1.35).

Conclusions

Use of social media platforms may help to both spread and dispel distorted science about nicotine. Addressing distorted science about nicotine is important, as it appears to be associated with more favourable views of the tobacco industry which may erode public support for effective regulation.
Evaluating the controlled reopening of nightlife during the COVID-19 pandemic: a matched cohort study in Sitges, Spain, in May 2021 (Reobrim Sitges)
Authors: Cunillera Puértolas Oriol , Contreras-Martos Sara , Marzo-Castillejo Mercè , López Gallegos Darío , Acedo Anta Mateo , Almeda Ortega Jesús , Colom Joan , Basora Josep , Salvador-Gonzalez Betlem
Published: June 2022

Objectives

To assess the impact of relaxing the state of alarm restrictions on SARS-CoV-2 infections at 14 days among people attending reopened nightclub venues.

Design

Matched cohort study with a paired control group (1:5 ratio).

Setting

Five small nightclubs with indoor areas and outdoor terraces, in a nightlife-restricted area in Sitges, Spain, on 20 May 2021. Wearing masks was mandatory, drinking was allowed and social distance was not required.

Participants

Volunteers were selected through a convenience sampling. To attend the event, participants were required to be older than 17 years, with a negative rapid antigen diagnostic test (Ag-RDT) on the same afternoon, without a positive reverse-transcription PCR (RT-PCR) or Ag-RDT and/or symptoms associated with COVID-19 in the previous 7 days, to not having knowingly been in close contact with someone infected in the previous 10 days and to not have knowingly had close contact with someone with a suspicion of COVID-19 in the previous 48 hours. A control group was paired by exact age, gender, residence municipality, socioeconomic index, previous SARS-CoV-2-confirmed infection and vaccination status, in a 1:5 ratio, from the primary care electronic health records.

Primary outcome

Evidence of infection at electronic health records by SARS-CoV-2 at 14-day follow-up.

Results

Among the 391 participants (median age 37 years; 44% (n=173) women), no positive SARS-CoV-2 cases were detected at 14 days, resulting in a cumulative incidence estimation of 0 (95% CI 0 to 943) per 100 000 inhabitants. In the control group, two cases with RT-PCR test were identified, resulting in a cumulative incidence of 102.30 (12.4 to 369) per 100 000 inhabitants.

Conclusions

Nightlife attendance under controlled conditions and with a requirement for a negative Ag-RDT was not associated with increased transmissibility of SARS-CoV-2 in a pandemic context of low infection rates. In such circumstances, secure opening of the nightlife sector was possible, under reduced capacity and controlled access by Ag-RDT, and environments where compliance with sanitary measures are maintainable.
Evaluating the governance and preparedness of the Lebanese health system for the COVID-19 pandemic: a qualitative study
Authors: Moussallem Marianne , Zein-El-Din Anna , Hamra Rasha , Rady Alissar , Kosremelli Asmar Michèle , Bou-Orm Ibrahim R
Published: June 2022

Objectives

This study aimed to assess the capacities and governance of Lebanon’s health system throughout the response to the COVID-19 pandemic until August 2020.

Design

A qualitative study based on semi-structured interviews.

Setting

Lebanon, February–August 2020.

Participants

Selected participants were directly or indirectly involved in the national or organisational response to the COVID-19 pandemic in Lebanon.

Results

A total of 41 participants were included in the study. ‘Hardware’ capacities of the system were found to be responsive yet deeply influenced by the challenging national context. The health workforce showed high levels of resilience, despite the shortage of medical staff and gaps in training at the early stages of the pandemic. The system infrastructure, medical supplies and testing capacities were sufficient, but the reluctance of the private sector in care provision and gaps in reimbursement of COVID-19 care by many health funding schemes were the main concerns. Moreover, the public health surveillance system was overwhelmed a few months after the start of the pandemic. As for the system ‘software’, there were attempts for a participatory governance mechanism, but the actual decision-making process was challenging with limited cooperation and strategic vision, resulting in decreased trust and increased confusion among communities. Moreover, the power imbalance between health actors and other stakeholders affected decision-making dynamics and the uptake of scientific evidence in policy-making.

Conclusions

Interventions adopting a centralised and reactive approach were prominent in Lebanon’s response to the COVID-19 pandemic. Better public governance and different reforms are needed to strengthen the health system preparedness and capacities to face future health security threats.
Striving for high reliability in healthcare: a qualitative study of the implementation of a hospital safety programme
Authors: Rotteau Leahora , Goldman Joanne , Shojania Kaveh G. , Vogus Timothy J. , Christianson Marlys , Baker G. Ross , Rowland Paula , Coffey Maitreya
Published: June 2022

Background

Healthcare leaders look to high-reliability organisations (HROs) for strategies to improve safety, despite questions about how to translate these strategies into practice. Weick and Sutcliffe describe five principles exhibited by HROs. Interventions aiming to foster these principles are common in healthcare; however, there have been few examinations of the perceptions of those who have planned or experienced these efforts.

Objective

This single-site qualitative study explores how healthcare professionals understand and enact the HRO principles in response to an HRO-inspired hospital-wide safety programme.

Methods

We interviewed 71 participants representing hospital executives, programme leadership, and staff and physicians from three clinical services. We observed and collected data from unit and hospital-wide quality and safety meetings and activities. We used thematic analysis to code and analyse the data.

Results

Participants reported enactment of the HRO principles ‘preoccupation with failure’, ‘reluctance to simplify interpretations’ and ‘sensitivity to operations’, and described the programme as adding legitimacy, training, and support. However, the programme was more often targeted at, and taken up by, nurses compared with other groups. Participants were less able to identify interventions that supported the HRO principles ‘commitment to resilience’ and ‘deference to expertise’ and reported limited examples of changes in practices related to these principles. Moreover, we identified inconsistent, and even conflicting, understanding of concepts related to the HRO principles, often related to social and professional norms and practices. Finally, an individualised rather than systemic approach hindered collective actions underlying high reliability.

Conclusion

Our findings demonstrate that the safety programme supported some HRO principles more than others, and was targeted at, and perceived differently across professional groups leading to inconsistent understanding and enactments of the principles across the organisation. Combining HRO-inspired interventions with more targeted attention to each of the HRO principles could produce greater, more consistent high-reliability practices.
Outcome differences between surgeons performing first and subsequent coronary artery bypass grafting procedures in a day: a retrospective comparative cohort study
Authors: Zhang Danwei , Gu Dachuan , Rao Chenfei , Zhang Heng , Su Xiaoting , Chen Sipeng , Ma Hanping , Zhao Yan , Feng Wei , Sun Hansong , Zheng Zhe
Published: June 2022

Background

With increasing surgical workload, it is common for cardiac surgeons to perform coronary artery bypass grafting (CABG) after other procedures in a workday. To investigate whether prior procedures performed by the surgeon impact the outcomes, we compared the outcomes between CABGs performed first versus those performed after prior procedures, separately for on-pump and off-pump CABGs as they differed in technical complexity.

Methods

We conducted a retrospective cohort study of patients undergoing isolated CABG in China from January 2013 to December 2018. Patients were categorised as undergoing on-pump and off-pump CABGs. Outcomes of the procedures performed first in primary surgeons’ daily schedule (first procedure) were compared with subsequent ones (non-first procedure). The primary outcome was an adverse events composite (AEC) defined as the number of adverse events, including in-hospital mortality, myocardial infarction, stroke, acute kidney injury and reoperation. Secondary outcomes were the individual components of the primary outcome, presented as binary variables. Mixed-effects models were used, adjusting for patient and surgeon-level characteristics and year of surgery.

Results

Among 21 866 patients, 10 109 (16.1% as non-first) underwent on-pump and 11 757 (29.6% as non-first) off-pump CABG. In the on-pump cohort, there was no significant association between procedure order and the outcomes (all p>0.05). In the off-pump cohort, non-first procedures were associated with an increased number of AEC (adjusted rate ratio 1.29, 95% CI 1.13 to 1.47, p<0.001), myocardial infarction (adjusted OR (ORadj) 1.43, 95% CI 1.13 to 1.81, p=0.003) and stroke (ORadj1.73, 95% CI 1.18 to 2.53, p=0.005) compared with first procedures. These increases were only found to be statistically significant when the procedure was performed by surgeons with <20 years’ practice or surgeons with a preindex volume <700 cases.

Conclusions

For a technically challenging surgical procedure like off-pump CABG, prior workload adversely affected patient outcomes.
Role of tumor infiltrating lymphocytes and spatial immune heterogeneity in sensitivity to PD-1 axis blockers in non-small cell lung cancer
Authors: Lopez de Rodas Miguel , Nagineni Venkata , Ravi Arvind , Datar Ila J , Mino-Kenudson Mari , Corredor German , Barrera Cristian , Behlman Lindsey , Rimm David L , Herbst Roy S , Madabhushi Anant , Riess Jonathan W , Velcheti Vamsidhar , Hellmann Matthew D , Gainor Justin , Schalper Kurt A
Published: June 2022

Background

Tumor infiltrating lymphocytes (TILs) reflect adaptive antitumor immune responses in cancer and are generally associated with favorable prognosis. However, the relationships between TILs subsets and their spatial arrangement with clinical benefit from immune checkpoint inhibitors (ICI) in non-small cell lung cancer (NSCLC) remains less explored.

Methods

We used multiplexed quantitative immunofluorescence panels to determine the association of major TILs subpopulations, CD8+cytotoxic T cells, CD4+helper T cells and CD20+B cells, and T cell exhaustion markers, programmed cell death protein-1 (PD-1),lymphocyte-activation gene 3 (LAG-3) and T cell immunoglobulin mucin-3 (TIM-3) with outcomes in a multi-institutional cohort of baseline tumor samples from 179 patients with NSCLC treated with ICI. The analysis of full-face tumor biopsies including numerous fields of view allowed a detailed spatial analysis and assessment of tumor immune heterogeneity using a multiparametric quadratic entropy metric (Rao’s Q Index (RQI)).

Results

TILs were preferentially located in the stromal tissue areas surrounding tumor-cell nests and CD8+T cells were the most abundant subset. Higher density of stromal CD8+cytotoxic T cells was significantly associated with longer survival, and this effect was more prominent in programmed death ligand-1 (PD-L1) positive cases. The role of baseline T cell infiltration to stratify PD-L1 expressing cases was confirmed measuring the T cell receptor-burden in an independent NSCLC cohort studied with whole-exome DNA sequencing. High levels of LAG-3 on T cells or elevated RQI heterogeneity index were associated with worse survival in the cohort.

Conclusion

Baseline T cell density and T cell exhaustion marker expression can stratify outcomes in PD-L1 positive patients with NSCLC treated with ICI. Spatial immune heterogeneity can be measured using the RQI and is associated with survival in NSCLC.
Cardiovascular medication in patients with raised NT-proBNP, but no heart failure in the SHEAF registry
Authors: Wolodimeroff Elena , Garg Pankaj , Swift Andrew J , Fent Graham , Lewis Nigel , Rogers Dominic , Charalampopoulos Athanasios , Al-Mohammad Abdallah
Published: June 2022

Objectives

We aim to assess the association of cardiovascular medications with outcomes of patients referred to the diagnostic heart failure (HF) clinic with symptoms or signs of possible HF, raised N-terminal pro-brain-type natriuretic peptide (NT-proBNP) but no evidence of HF on transthoracic echocardiography (TTE).

Methods

Data were collected prospectively into the Sheffield HEArt Failure (SHEAF) registry between April 2012 and January 2020. The inclusion criteria were symptoms or signs suggestive of HF, NT-proBNP >400 pg/mL, but no evidence of HF on TTE. Cox proportional-hazards regression model was used to investigate the association between the survival time of patients and different cardiovascular medications. The outcome was defined as all-cause mortality.

Results

From the SHEAF registry, we identified 1766 patients with raised NT-proBNP with no evidence of HF on TTE. Survival was higher among the younger patients, and among those with hypertension or atrial fibrillation (AF). Mortality was increased with male gender, valvular heart disease and chronic kidney disease. Using univariate Cox proportional-hazards regression, the only cardiac therapeutic agent independently associated with all-cause mortality was beta-blocker (HR 0.86; 95% CI: 0.77 to 0.97; p=0.02). The use of beta-blockers was significantly higher in patients with AF (63% vs 39%, p<0.01) and hypertension (51% vs 42%, p<0.01). However, using multivariate Cox proportional-hazards regression to adjust for all variables associated with mortality, the influence of beta-blockers became non-significant (HR 0.96; 95% CI: 0.85 to 1.1, p=0.49).

Conclusion

When all variables associated with mortality are considered, none of the cardiovascular agents are associated with the improved survival of patients with suspected HF, raised NT-proBNP but no HF on echocardiography.
High rate of left ventricular hypertrophy on screening echocardiography among adults living with HIV in Malawi
Authors: Hoffman Risa M , Chibwana Florence , Banda Ben Allan , Kahn Daniel , Gama Khumbo , Boas Zachary P , Chimombo Mayamiko , Kussen Chiulemu , Currier Judith S , Namarika Dan , van Oosterhout Joep , Phiri Sam , Moses Agnes , Currier Jesse W , Sigauke Hitler , Moucheraud Corrina , Canan Tim
Published: June 2022

Background

There are limited data on structural heart disease among people living with HIV in southern Africa, where the success of antiretroviral therapy (ART) has drastically improved life expectancy and where risk factors for cardiovascular disease are prevalent.

Methods

We performed a cross-sectional study of screening echocardiography among adults (≥18 years) with HIV in Malawi presenting for routine ART care. We used univariable and multivariable logistic regression to evaluate correlates of abnormal echocardiogram.

Results

A total of 202 individuals were enrolled with a median age of 45 years (IQR 39–52); 52% were female, and 27.7% were on antihypertensive medication. The most common clinically significant abnormality was left ventricular hypertrophy (LVH) (12.9%, n=26), and other serious structural heart lesions were rare (<2% with ejection fraction less than 40%, moderate-severe valve lesions or moderate-severe pericardial effusion). Characteristics associated with abnormal echocardiogram included older age (OR 1.04, 95% CI 1.01 to 1.08), higher body mass index (OR 1.09, 95% CI 1.02 to 1.17), higher mean systolic blood pressure (OR 1.03, 95% CI 1.02 to 1.05) and higher mean diastolic blood pressure (OR 1.03, 95% CI 1.01 to 1.05). In a multivariable model including age, duration on ART, body mass index, and systolic and diastolic blood pressure, only mean body mass index (adjusted OR 1.10, 95% CI 1.02 to 1.19), systolic blood pressure (aOR 1.05, 95% CI 1.03 to 1.08) and diastolic blood pressure (aOR 0.96, 95% CI 0.92 to 1.00) remained associated with abnormal echocardiogram.

Conclusions

LVH was common in this population of adults on ART presenting for routine care and was associated with elevated blood pressure. Further research is needed to characterise the relationship between chronic hypertension, LVH and downstream consequences, such as diastolic dysfunction and heart failure in people living with HIV.
Evaluation of the Beaufort Sea shelf structure and function in support of the Tarium Niryutait Marine Protected Area
Authors: Sora Kristen J. , Wabnitz Colette C.C. , Steiner Nadja S. , Sumaila U. Rashid , Cheung William W.L. , Niemi Andrea , Loseto Lisa L. , Hoover Carie
Published: June 2022

Arctic ecosystems are at risk to climate impacts, challenging existing conservation measures such as protected areas. This study aims to describe the ecological dynamics of the Canadian Beaufort Sea Shelf (BSS) ecosystem and the Tarium Niryutait Marine Protected Area (TNMPA) under historical changes in sea surface temperature and sea ice extent. Using Ecopath with Ecosim, we compared the status of the BSS between two time periods, 1970–1974 and 2008–2012, and against four ecosystem models (Eastern Chukchi Sea, Barents Sea, Eastern Bering Sea, Gulf of Alaska) to inform the relative long-term health and status of Arctic marine ecosystems. We find that relative to the comparable ecosystems, the BSS had a greater proportion of biomass from pelagic primary and secondary producers, and limited production from higher trophic levels. Estimates of trophic structure indices for the BSS indicate temporal ecosystem stability, and no loss in diversity. While beluga whales are a focus of the TNMPA management plan, they are not considered a key component of the modeled food web. Rather, Arctic and polar cods (main beluga prey group), arthropods, large copepods, micro-zooplankton, and herring and smelt, were identified as keystone species and warrant attention as proxies for both beluga whales and ecosystem health.
Oligomerization of an ansa-ferrocene with pyrazabole bridge
Authors: Dörr Jonas , Alahmadi Abdullah F. , Henkelmann Marcel , Bolte Michael , Lerner Hans-Wolfram , Wagner Matthias , Jäkle Frieder
Published: June 2022

ansa-Ferrocenes with pyrazabole bridges are chemically robust entities and therefore suitable building blocks for the synthesis of rigid-rod polymers that combine redox-active Fe(II) centers and beltene-like π faces. The specific monomers we developed bear OEt groups at both tetracoordinated boron atoms (for solubility reasons) and ethynyl substituents at the 4-positions of the two pyrazole rings. Polymerization was accomplished by a condensation reaction with 1,4-diiodobenzene using a Sonogashira–Hagihara-type protocol. As a result, oligomers with a number-average molecular weight of Mn = 7.6 kDa and dispersity of Ð = 1.55 were obtained, suggesting an average chain length of about 14 repeating units based on gel permeation chromatography analysis in THF relative to narrow polystyrene standards. The molecular weight determination was complemented by MALDI-TOF mass spectrometry and (heteronuclear) NMR spectroscopy to verify the intact pyrazabole monomer repeat units and the nature of the end groups. The oligomers were further characterized by UV–vis spectroscopy and cyclic voltammetry, which demonstrated the successful synthesis of a new class of redox-active materials.