bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterisation of asymptomatic patients and efficacy of preventive measures for SARS-CoV-2 infection in a large population of Southern Italy: a cohort study
Authors: Masarone Mario , Vaccaro Emilia , Sciorio Roberta , Torre Pietro , Della Vecchia Antonio , Aglitti Andrea , Caliulo Rita , Borrelli Anna , Persico Marcello
Published: May 2021

Background

The SARS-CoV-2 pandemic has infected millions of people and has caused more than 2.30 million deaths worldwide to date. Several doubts arise about the role of asymptomatic carriers in virus transmission. During the first epidemic outbreak in Italy a large screening with nasopharyngeal swab (NS) was performed in those who were considered ‘suspect’ for infection.

Aims

To report the results of the SARS-CoV-2 screening in a province in Southern Italy and to provide data on the COVID-19 epidemic and the burden of asymptomatic subjects.

Patients and methods

A retrospective cohort study was set up in all healthcare facilities of the province (12 hospitals and 13 sanitary districts: primary, secondary and tertiary centres) with the aim to analyse the results of NS performed on all subjects suspected to be infected with SARS-CoV-2, either because they presented symptoms suggestive of SARS-CoV-2 infection, they were ‘contacts’ of positive subjects, they came from areas with high prevalence or they were healthcare workers. NS were performed and managed as indicated by international guidelines. The specimens were processed for SARS-CoV-2 detection by real-time PCR.

Results

A total of 20 325 NS were performed from 13 March to 9 May 2020. Of these, 638 (3.14%) were positive. 470 were asymptomatic, or 75.3% of persons who were positive. They were mostly among ‘contacts’ of symptomatic cases (428 of 470, 91%) and were in domiciliary isolation. Expression of three SARS-CoV-2 genes did not differ between asymptomatic and symptomatic subjects. The strict measures with regard to social distancing led to a continuous decrease in cases during phase 1.

Conclusions

In a large area in Southern Italy, 3.14% (638 of 20 325) of the total subjects tested were positive for SARS-CoV-2. Most of them were asymptomatic (470 of 624, 75.3%), and of these 91% (428 of 470) were ‘close contacts’ of symptomatic subjects. The combination of social distancing together with the systematic screening of close contacts of COVID-19-positive symptomatic subjects seems to be an efficacious approach to limit the spread of the epidemic.
Study protocol for a phase II randomised, double-blind, placebo-controlled trial of perampanel as an antiepileptogenic treatment following acute stroke
Authors: Nicolo John-Paul , Chen Zhibin , Moffat Bradford , Wright David K , Sinclair Benjamin , Glarin Rebecca , Neal Andrew , Thijs Vincent , Seneviratne Udaya , Yan Bernard , Cloud Geoffrey , O"Brien Terence J , Kwan Patrick
Published: May 2021

Introduction

Stroke is a common cause of epilepsy that may be mediated via glutamate dysregulation. There is currently no evidence to support the use of antiseizure medications as primary prevention against poststroke epilepsy. Perampanel has a unique antiglutamatergic mechanism of action and may have antiepileptogenic properties. This study aims to evaluate the efficacy and safety of perampanel as an antiepileptogenic treatment in patients at high risk of poststroke epilepsy.

Methods and analysis

Up to 328 patients with cortical ischaemic stroke or lobar haemorrhage will be enrolled, and receive their first treatment within 7 days of stroke onset. Patients will be randomised (1:1) to receive perampanel (titrated to 6 mg daily over 4 weeks) or matching placebo, stratified by stroke subtype (ischaemic or haemorrhagic). Treatment will be continued for 12 weeks after titration. 7T MRI will be performed at baseline for quantification of cerebral glutamate by magnetic resonance spectroscopy and glutamate chemical exchange saturation transfer imaging. Blood will be collected for measurement of plasma glutamate levels. Participants will be followed up for 52 weeks after randomisation.

The primary study outcome will be the proportion of participants in each group free of late (more than 7 days after stroke onset) poststroke seizures by the end of the 12-month study period, analysed by Fisher’s exact test. Secondary outcomes will include time to first seizure, time to treatment withdrawal and 3-month modified Rankin Scale score. Quality of life, cognitive function, mood and adverse events will be assessed by standardised questionnaires. Exploratory outcomes will include correlation between cerebral and plasma glutamate concentration and stroke and seizure outcomes.

Ethics and dissemination

This study was approved by the Alfred Health Human Research Ethics Committee (HREC No 44366, Reference 287/18).

Trial registration number

ACTRN12618001984280; Pre-results.
Interventions and strategies involving primary healthcare professionals to manage emergency department overcrowding: a scoping review
Authors: Jeyaraman Maya M , Copstein Leslie , Al-Yousif Nameer , Alder Rachel N , Kirkland Scott W , Al-Yousif Yahya , Suss Roger , Zarychanski Ryan , Doupe Malcolm B , Berthelot Simon , Mireault Jean , Tardif Patrick , Askin Nicole , Buchel Tamara , Rabbani Rasheda , Beaudry Thomas , Hartwell Melissa , Shimmin Carolyn , Edwards Jeanette , Halas Gayle , Sevcik William , Tricco Andrea C , Chochinov Alecs , Rowe Brian H , Abou-Setta Ahmed M
Published: May 2021

Objectives

To conduct a scoping review to identify and summarise the existing literature on interventions involving primary healthcare professionals to manage emergency department (ED) overcrowding.

Design

A scoping review.

Data sources

A comprehensive database search of Medline (Ovid), EMBASE (Ovid), Cochrane Library (Wiley) and CINAHL (EBSCO) databases was conducted (inception until January 2020) using peer-reviewed search strategies, complemented by a search of grey literature sources.

Eligibility criteria

Interventions and strategies involving primary healthcare professionals (PHCPs: general practitioners (GPs), nurse practitioners (NPs) or nurses with expanded role) to manage ED overcrowding.

Methods

We engaged and collaborated, with 13 patient partners during the design and conduct stages of this review. We conducted this review using the JBI guidelines. Two reviewers independently selected studies and extracted data. We conducted descriptive analysis of the included studies (frequencies and percentages).

Results

From 23 947 records identified, we included 268 studies published between 1981 and 2020. The majority (58%) of studies were conducted in North America and were predominantly cohort studies (42%). The reported interventions were either ‘within ED’ (48%) interventions (eg, PHCP-led ED triage or fast track) or ‘outside ED’ interventions (52%) (eg, after-hours GP clinic and GP cooperatives). PHCPs involved in the interventions were: GP (32%), NP (26%), nurses with expanded role (16%) and combinations of the PHCPs (42%). The ‘within ED’ and ‘outside ED’ interventions reported outcomes on patient flow and ED utilisation, respectively.

Conclusions

We identified many interventions involving PHCPs that predominantly reported a positive impact on ED utilisation/patient flow metrics. Future research needs to focus on conducting well-designed randomized controlled trials (RCTs) and systematic reviews to evaluate the effectiveness of specific interventions involving PHCPs to critically appraise and summarise evidence on this topic.
Electronic alerts for acute kidney injury across primary and secondary care
Authors: Barker Joseph , Smith-Byrne Karl , Sayers Oliver , Joseph Krishan , Sleeman Mark , Lasserson Daniel , Vaux Emma
Published: May 2021

Problem

In 2009 the National Confidential Enquiry into Patient Outcome and Death suggested only 50% of patients with acute kidney injury (AKI) receive good standards of care. In response National Health Service (NHS) England mandated the use of electronic AKI alerts within secondary care. However, we recognised AKI is not just a secondary care problem, where primary care has a crucial role to play in prevention, early detection and management as well as post-AKI care.

Methods

AKI alerts were implemented in primary and secondary care services for a population of 480 000. Comparisons were made in AKI incidence, peak creatinine following AKI and renal recovery in the years before and after using Byar’s approximation (95% CI).

Intervention

A complex quality improvement initiative was implemented based on the design and integration of an AKI alerting system within laboratory information management systems for primary and secondary care, with an affixed URL for clinicians to access a care bundle of AKI guidelines on safe prescribing, patient advice and early contact with nephrology.

Results

The intervention was associated with an 8% increase in creatinine testing (n=32 563). Hospital acquired AKI detection increased by 6%, while community acquired AKI detection increased by 3% and AKI stage 3 detected in primary care fell by 14%. The intervention overall had no effect on AKI severity but did improve follow-up testing and renal recovery. Importantly hospital AKI 3 recoveries improved by 22%. In a small number of AKI cases, the algorithm did not produce an alert resulting in a reduction in follow-up testing compared with preintervention levels.

Conclusion

The introduction of AKI alerts in primary and secondary care, in conjunction with access to an AKI care bundle, was associated with higher rates of repeat blood sampling, AKI detection and renal recovery. Validating accuracy of alerts is required to avoid patient harm.
Staff–pupil SARS-CoV-2 infection pathways in schools in Wales: a population-level linked data approach
Authors: Thompson Daniel A , Abbasizanjani Hoda , Fry Richard , Marchant Emily , Griffiths Lucy , Akbari Ashley , Hollinghurst Joe , North Laura , Lyons Jane , Torabi Fatemeh , Davies Gareth , Gravenor Mike B , Lyons Ronan A
Published: May 2021

Background

Better understanding of the role that children and school staff play in the transmission of SARS-CoV-2 is essential to guide policy development on controlling infection while minimising disruption to children’s education and well-being.

Methods

Our national e-cohort (n=464531) study used anonymised linked data for pupils, staff and associated households linked via educational settings in Wales. We estimated the odds of testing positive for SARS-CoV-2 infection for staff and pupils over the period August– December 2020, dependent on measures of recent exposure to known cases linked to their educational settings.

Results

The total number of cases in a school was not associated with a subsequent increase in the odds of testing positive (staff OR per case: 0.92, 95% CI 0.85 to 1.00; pupil OR per case: 0.98, 95% CI 0.93 to 1.02). Among pupils, the number of recent cases within the same year group was significantly associated with subsequent increased odds of testing positive (OR per case: 1.12, 95% CI 1.08 to 1.15). These effects were adjusted for a range of demographic covariates, and in particular any known cases within the same household, which had the strongest association with testing positive (staff OR: 39.86, 95% CI 35.01 to 45.38; pupil OR: 9.39, 95% CI 8.94 to 9.88).

Conclusions

In a national school cohort, the odds of staff testing positive for SARS-CoV-2 infection were not significantly increased in the 14-day period after case detection in the school. However, pupils were found to be at increased odds, following cases appearing within their own year group, where most of their contacts occur. Strong mitigation measures over the whole of the study period may have reduced wider spread within the school environment.
Comparative efficacy and safety of interventions for treating head lice: a protocol for systematic review and network meta-analysis
Authors: Stevenson Bill , Tesfaye Wubshet , Christenson Julia , Mathew Cynthia , Abrha Solomon , Peterson Gregory , Samarawickrema Indira , Thomas Jackson
Published: May 2021

Background

Head lice infestation is a major public health problem around the globe. Its treatment is challenging due to product failures resulting from rapidly emerging resistance to existing treatments, incorrect treatment applications and misdiagnosis. Various head lice treatments with different mechanism of action have been developed and explored over the years, with limited report on systematic assessments of their efficacy and safety. This work aims to present a robust evidence summarising the interventions used in head lice.

Method

This is a systematic review and network meta-analysis which will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement for network meta-analyses. Selected databases, including PubMed, Embase, MEDLINE, Web of Science, CINAHL and Cochrane Central Register of Controlled Trials will be systematically searched for randomised controlled trials exploring head lice treatments. Searches will be limited to trials published in English from database inception till 2021. Grey literature will be identified through Open Grey, AHRQ, Grey Literature Report, Grey Matters, ClinicalTrials.gov, WHO International Clinical Trials Registry and International Standard Randomised Controlled Trials Number registry. Additional studies will be sought from reference lists of included studies. Study screening, selection, data extraction and assessment of methodological quality will be undertaken by two independent reviewers, with disagreements resolved via a third reviewer. The primary outcome measure is the relative risk of cure at 7 and 14 days postinitial treatment. Secondary outcome measures may include adverse drug events, ovicidal activity, treatment compliance and acceptability, and reinfestation. Information from direct and indirect evidence will be used to generate the effect sizes (relative risk) to compare the efficacy and safety of individual head lice treatments against a common comparator (placebo and/or permethrin). Risk of bias assessment will be undertaken by two independent reviewers using the Cochrane Risk of Bias tool and the certainty of evidence assessed using the Grading of Recommendations, Assessment, Development and Evaluations guideline for network meta-analysis. All quantitative analyses will be conducted using STATA V.16.

Discussion

The evidence generated from this systematic review and meta-analysis is intended for use in evidence-driven treatment of head lice infestations and will be instrumental in informing health professionals, public health practitioners and policy-makers.

PROSPERO registration number

CRD42017073375.
Overuse of diagnostic testing in healthcare: a systematic review
Authors: Müskens Joris L J M , Kool Rudolf Bertijn , van Dulmen Simone A , Westert Gert P
Published: May 2021

Background

Overuse of diagnostic testing substantially contributes to healthcare expenses and potentially exposes patients to unnecessary harm. Our objective was to systematically identify and examine studies that assessed the prevalence of diagnostic testing overuse across healthcare settings to estimate the overall prevalence of low-value diagnostic overtesting.

Methods

PubMed, Web of Science and Embase were searched from inception until 18 February 2020 to identify articles published in the English language that examined the prevalence of diagnostic testing overuse using database data. Each of the assessments was categorised as using a patient-indication lens, a patient-population lens or a service lens.

Results

118 assessments of diagnostic testing overuse, extracted from 35 studies, were included in this study. Most included assessments used a patient-indication lens (n=67, 57%), followed by the service lens (n=27, 23%) and patient-population lens (n=24, 20%). Prevalence estimates of diagnostic testing overuse ranged from 0.09% to 97.5% (median prevalence of assessments using a patient-indication lens: 11.0%, patient-population lens: 2.0% and service lens: 30.7%). The majority of assessments (n=85) reported overuse of diagnostic testing to be below 25%. Overuse of diagnostic imaging tests was most often assessed (n=96). Among the 33 assessments reporting high levels of overuse (≥25%), preoperative testing (n=7) and imaging for uncomplicated low back pain (n=6) were most frequently examined. For assessments of similar diagnostic tests, major variation in the prevalence of overuse was observed. Differences in the definitions of low-value tests used, their operationalisation and assessment methods likely contributed to this observed variation.

Conclusion

Our findings suggest that substantial overuse of diagnostic testing is present with wide variation in overuse. Preoperative testing and imaging for non-specific low back pain are the most frequently identified low-value diagnostic tests. Uniform definitions and assessments are required in order to obtain a more comprehensive understanding of the magnitude of diagnostic testing overuse.
Association of the British Athletic Muscle Injury Classification and anatomic location with return to full training and reinjury following hamstring injury in elite football
Authors: Shamji Ricky , James Steven L J , Botchu Rajesh , Khurniawan Kent A , Bhogal Gurjit , Rushton Alison
Published: May 2021

Background

The relationship between hamstring muscle injuries (HMIs) that involve the intramuscular tendon and prolonged recovery time and increased reinjury rate remains unclear in elite footballers.

Objective

To determine the association of time to return to full training (TRFT) and reinjury of HMIs using the British Athletic Muscle Injury Classification (BAMIC) and specific anatomical injury location in elite-level football players.

Methods

The electronic medical records of all players at an English Premier League club were reviewed over eight consecutive seasons. All players who sustained an acute HMI were included. Two experienced musculoskeletal radiologists independently graded each muscle using the BAMIC, categorised each injury location area (proximal vs middle vs distal third and proximal vs distal tendon) and reported second muscle involvement. TRFT and reinjury were recorded.

Results

Out of 61 HMIs, the intramuscular tendon (BAMIC ‘c’) was involved in 13 (21.3%). HMI involving the intramuscular tendon (‘c’) had a mean rank TRFT of 36 days compared with 24 days without involvement (p=0.013). There were 10 (16.4%) reinjuries with a significant difference of 38.5% reinjury rate in the group with intramuscular tendon injury (‘c’) and 12.5% in the group without (p=0.031). TRFT and reinjury involving a second muscle was statistically significantly higher than without. Most of the HMIs to the biceps femoris with reinjury (5 out of 9) were in the distal third section related to the distal tendon site involving both the long and short head.

Conclusion

TRFT in HMI involving the intramuscular tendon (‘c’) of the Biceps femoris is significantly longer with significantly higher reinjury rate compared with injuries without, in elite football players. The finding that most reinjures of the biceps femoris occurring in the distal third muscle at the distal tendon site, involving both the long and short head, merits further investigation.
Drug sellers’ knowledge and practices, and client perspectives after an intervention to improve the quality of safe abortion care outside of formal clinics in Nigeria
Authors: Adojutelegan Yinka Abiola , Coughlin Amy J , Shellenberg Kristen , Oginni Ayodeji Babatunde , Okeke Bridget , Ogueji Okechi
Published: May 2021

Background

In Nigeria, where abortion is legally restricted, individuals seek medication abortion drugs, including misoprostol, directly from pharmacies or drug sellers. However, knowledge of drug sellers or patent medicine vendors (PMVs) dispensation practices and women’s experience with self-management is limited and research suggests poor quality of services. This study assesses the knowledge and practices of PMVs and women’s experiences after a harm reduction intervention to improve the provision of medication abortion using misoprostol.

Methods

We conducted a retrospective descriptive analysis of anonymised logbook data collected from 141 Nigerian PMVs who provided misoprostol for abortion to 4924 clients between February 2015 and July 2018. We conducted a descriptive analysis of self-reported misoprostol dispensation practices with data from a cross-sectional survey of PMVs (n=120) from June 2016 to December 2018. We collected data on women’s experience obtaining misoprostol from 37 PMVs through a cross-sectional survey of women (n=260) from 4–19 June 2018.

Results

For clients where the misoprostol dose dispensed was recorded (n=3784), 86% of clients were given 800 μg or more misoprostol, pain medication (97%) and a contraceptive method (92%). Most clients with an outcome recorded in the logbook (n=4431) had a complete abortion (86%). Almost all women reported that they would return to the PMV for future services (99%).

Conclusions

The majority of PMVs dispensed misoprostol in appropriate dosages and provided clients with information on drug administration and methods of contraception. Interventions designed to improve PMVs’ best practices around the provision of abortion care may help ensure the quality of services received by clients.
Could routine pregnancy self-testing facilitate earlier recognition of unintended pregnancy? A feasibility study among South African women
Authors: Constant Deborah , Lopes Sofia , Grossman Daniel
Published: May 2021

Introduction

We explored whether routine pregnancy self-testing is feasible and acceptable to women at risk of late recognition of pregnancy as a strategy to facilitate early entry into either antenatal or abortion care.

Methods

A feasibility study among South African sexually active women not desiring pregnancy within 1 year, and not using long-acting or injectable contraceptives. At recruitment, we provided five free urine pregnancy tests for self-testing on the first day of each of the next 3 months. We sent monthly text reminders to use the tests with requests for no-cost text replies. Our main outcome was the proportion of participants self-testing within 5 days of the text reminder over three consecutive months. Other outcomes were ease of use of tests, preference for self-testing versus clinic testing, acceptability of routine self-testing (all binary responses followed by open response options) and response to text messages (four-point Likert scale).

Results

We followed up 71/76 (93%) participants. Two confirmed new pregnancies at the first scheduled test and completed exit interviews, and 64/69 (93%) self-reported completing all three monthly tests. Self-testing was easy to do (66/71, 93%); advantages were convenience (21/71, 30%) and privacy (18/71, 25%), while the main disadvantage was no nurse present to advise (17/71, 24%). Most would recommend monthly testing (70/71, 99%). Text reminders were generally not bothersome (57/71, 80%); 35/69 (51%) participants replied with test results over all three months.

Conclusion

Providing free pregnancy tests to women at risk of late recognition of pregnancy is feasible to strengthen early confirmation of pregnancy status.
Benefits of sodium glucose cotransporter 2 inhibitors across the spectrum of cardiovascular diseases
Authors: Gulsin Gaurav S , Graham-Brown Matthew P M , Squire Iain B , Davies Melanie J , McCann Gerry P
Published: May 2021

Sodium glucose cotransporter 2 inhibitors (SGLT2i) have emerged as a class of medications with positive cardiovascular (CV) effects across a spectrum of patients with and without type 2 diabetes (T2D). In heart failure with reduced ejection fraction, there is clear evidence that SGLT2i reduce hospitalisations and mortality regardless of the presence of diabetes, and they are now recognised as the fourth pillar of pharmacological management. Recent trial data also indicate promising effects in heart failure with preserved ejection fraction. In patients with T2D and atherosclerotic CV diseases, multiple CV outcomes trials have shown reductions in major adverse CV events. Meta-analysis of these trials also shows lower rates of incident and recurrent atrial fibrillation with SGLT2i. Concerns regarding utilisation in patients with chronic kidney disease have been allayed in trials showing SGLT2i in fact have renoprotective effects. Questions still remain regarding the safety of SGLT2i in the acute heart failure setting and immediately post myocardial infarction, as well as in patients with more advanced stages of chronic kidney disease. Furthermore, studies are underway evaluating SGLT2i in patients with heart valve disease, where positive effects on left ventricular remodelling may, for example, improve functional mitral regurgitation. In this review, we summarise the available evidence of recent CV outcomes trials of SGLT2i, focusing particularly on the application of these agents across various CV diseases. We detail evidence to support increased utilisation of these drugs, which in many cases will reduce mortality and improve quality of life in patients routinely encountered by the CV specialist physician.
Pan-cancer landscape ofCD274(PD-L1) copy number changes in 244 584 patient samples and the correlation with PD-L1 protein expression
Authors: Huang Richard S.P. , Murugesan Karthikeyan , Montesion Meagan , Pavlick Dean C. , Mata Douglas A. , Hiemenz Matthew C. , Decker Brennan , Frampton Garrett , Albacker Lee A. , Ross Jeffrey S.
Published: May 2021

Introduction

Several studies have shown clinical outcomes data that support the use ofCD274 (PD-L1) copy-number (CN) gains and/or losses as a biomarker for immune checkpoint inhibitor (ICPI). Here, we present the landscape ofCD274CN changes across a large cohort of solid tumor cases and correlate these with PD-L1 protein expression by immunohistochemistry.

Methods

We analyzed all cases that underwent comprehensive genomic profiling (CGP) testing at Foundation Medicine between August 2014 and June 2020.CD274CN changes were correlated with PD-L1 expression in tumor types where there were Food and Drug Administration approved companion diagnostic (CDx) claims and the CDx assay was used to assess PD-L1 expression.

Results

In all, 244 584 samples representing 290 solid tumor types were included in the study. Overall, 17.6% (42 983/244 584) hadCD274CN gains (>specimen ploidy), 44.6% (108 970/244 584) wereCD274CN neutral, and 37.9% (92 631/244 584) hadCD274CN loss. Using different CN cut offs to defineCD274positivity resulted in different prevalence estimates: ploidy +1, 17.4% (42 636/244 584); ploidy +2, 6.2% (15 183/244 584); ploidy +3, 2.2% (5375/244 584); ploidy +4, 1.1% (2712/244 584); and ploidy +8, 0.2% (434/244 584). The prevalence of CN changes and CN positivity varied based on tumor type.CD274CN gains were significantly associated with PD-L1 positivity in NSCLC, urothelial carcinoma, breast carcinoma, cervical carcinoma, esophagus squamous cell carcinoma (SCC) and head and neck SCC (ORs 3.3, 3.0, 2.0, 4.5. 3.8, 8.4, 1.4, respectively; p<0.05) and with microsatellite instability status in only clinically relevant tumor types (gastric adenocarcinoma, colorectal adenocarcinoma, uterine endometrial adenocarcinoma, esophageal adenocarcinoma and gastroesophageal junction adenocarcinoma (OR: 5.2, 1.9, 3.2, 3.7 and 6.5, respectively; p<0.05)). Conversely,CD274CN changes were not significantly correlated with tumor mutational burden in almost all the tumor types.

Conclusion

CD274CN changes and PD-L1 expression were highly correlated in multiple tumor types. These prevalence data onCD274CN changes across a large cohort of different solid tumors can be used to design future clinical studies to assess whetherCD274CN changes could be a potential biomarker for ICPI.
Quick Systemic Lupus Activity Questionnaire (Q-SLAQ): a simplified version of SLAQ for patient-reported disease activity
Authors: Svenungsson Elisabet , Gunnarsson Iva , Illescas-Bäckelin Vera , Trysberg Estelle , Jönsen Andreas , Leonard Dag , Sjöwall Christopher , Pettersson Susanne
Published: May 2021

Objectives

Most indices of disease activity in SLE combine physicians’ assessments and laboratory tests. However, there is also a need to capture patients’ perspectives of disease activity. Consequently, we need new, preferably quick and easy instruments to collect this information, which can be very useful for online consultations and registry purposes. We compared patients’ assessments of SLE disease impact/activity, as reported by a shorter version of the Quick Systemic Lupus Activity Questionnaire (Q-SLAQ), with physicians’ assessments using SLE Activity Measure (SLAM) and SLE Disease Activity Index (SLEDAI-2K) and with the original Systemic Lupus Activity Questionnaire (SLAQ).

Methods

Patients with SLE (n=115), with a disease duration of 15 years (IQR 17), completed the Q-SLAQ prior to physicians’ assessments by SLAM and SLEDAI-2K. A second set of patients (n=85) with similar characteristics filled out Q-SLAQ and SLAQ. Spearman’s ρ correlations were explored between patients’ total Q-SLAQ and subscales (Symptom Score, Patient’s Global Disease Activity) and physicians’ SLAM and SLEDAI-2K, with and without laboratory items (SLAM-nolab and SLEDAI-2K-nolab) and SLAQ. Corresponding items in Q-SLAQ and SLAM were compared.

Results

Correlations between patients’ and physicians’ assessments were higher for SLAM-nolab (total Q-SLAQ, ρ=0.71; Symptom Score, ρ=0.67; and Patient’s Global Disease Activity, ρ=0.68) than for the original SLAM (total Q-SLAQ, ρ=0.53; Symptom Score, ρ=0.50; and Patient’s Global Disease Activity, ρ=0.53). Regarding specific symptoms, fatigue (ρ=0.72) and alopecia (ρ=0.71) correlated best, while pulmonary/respiratory symptoms correlated least (ρ=0.19, p=0.039). Physicians assessment with SLEDAI-2K-nolab correlated weakly with patients’ assessments (total Q-SLAQ, ρ=0.30; Symptom Score, ρ=0.30; and Patient’s Global Disease Activity, ρ=0.36). Bivariate correlations between Q-SLAQ and SLAQ were good (ρ=0.82–0.96).

Conclusions

Q-SLAQ and the original SLAQ performed equally well, demonstrating that the shorter Q-SLAQ can safely be used to monitor patients’ perception of disease impact/activity. We also noted an intriguing discrepancy between physicians’ and patients’ evaluations of pulmonary/respiratory symptoms, which requires further investigations.
Cross-sectional assessment of haemostatic profile and hepatic dysfunction in Fontan patients
Authors: Daems Joelle Julius Nicolaas , Attard Chantal , Van Den Helm Suelyn , Breur Johannes , D'Udekem Yves , du Plessis Karin , Wilson Thomas G , Winlaw David , Gentles Thomas L , Monagle Paul , Ignjatovic Vera
Published: May 2021

Background

Fontan-associated liver disease is accompanied by a hypercoagulable state. While hepatic dysfunction in Fontan patients is common, its relationship with haemostatic changes and clinical outcomes in this patient population remains unclear.

Objective

To correlate liver dysfunction and haemostatic profiles with clinical outcomes in the Fontan population.

Patients/methods

Patients were enrolled in a multicentre, cross-sectional study in Australia and New Zealand. Hepatic structure and function were assessed using serum-based calculations (Fibrotest and model for end-stage liver disease excluding international normalised ratio scores). Haemostatic profiles were assessed by Thrombin Generation. Platelet function was assessed via Platelet Factor 4 (PF4) and P-selectin (P-SEL). Clinical outcomes were obtained from the Australian and New Zealand Fontan Registry.

Results

Seventy-three patients participated in the study (mean age 18.9±8.5 years with a mean of 13.5±6.9 years post-Fontan). The Endogenous Thrombin Potential (ETP) for patients who suffered thrombotic events (TE) (1366.4±66.2 nM/min) was higher compared with patients with major bleeding events (1011.1±138.4 nM/min) (p=0.03). Except for a negative correlation between Fibrotest-score and PF4 (p=0.045), PF4 and P-SEL concentrations did not correlate with markers of hepatic dysfunction or structural abnormality.

Conclusions

Increased ETP is associated with TE during clinical follow-up after Fontan. This study reinforces that hepatic dysfunction may contribute to the derangement of coagulation factors, impacting the individual risk of haemostatic complications for the Fontan population.
Germination ecology of Trachycarpus fortunei (Arecaceae), a species with morphophysiological and shoot dormancy
Authors: Jaganathan Ganesh K. , Bayarkhuu Narangua , He LanLan , Liu Baolin , Li Jiajin , Han Yingying
Published: May 2021

Beyond strong inference that most of the 2600 known species of Arecaceae produce diaspores with an underdeveloped embryo and therefore have morphological dormancy (MD) or morphophysiological dormancy (MPD), little is known about the specific dormancy class or sub-class and how dormancy-break occurs under ecological conditions. Here, we found that mature seeds of Trachycarpus fortunei (Hook.) H.Wendl. collected at the time of natural dispersal had an underdeveloped embryo that was 10% of total seed length. No diaspores germinated over a wide range of temperatures in either light or darkness. Cold stratification at 4 °C for one, two, and three months or treatment with 100, 500, and 1000 ppm gibberellic acid (GA3) improved germination percentages, with three months cold stratification or 1000 ppm GA3 resulting in highest germination. The embryo grew inside the seeds during cold stratification; however, warm stratification did not improve germination. Therefore, seeds of T. fortunei have intermediate complex MPD. Cold-stratified seeds that were moved to spring conditions (night and day temperatures of 15 and 20 °C, respectively) had cotyledonary petiole (CP) elongated, but leaves developed only when the CP elongated seeds were moved to summer temperatures (night and day temperatures of 25 and 30 °C, respectively), suggesting the presence of shoot dormancy. The seedlings are remote-tubular type. This is the first report for Arecaceae indicating the presence of complex MPD.
Testing leptoquark/EFT in $${\bar{B}} \rightarrow {D^{(*)}}l{\bar{\nu }}$$ at the LHC
Authors: Iguro Syuhei , Takeuchi Michihisa , Watanabe Ryoutaro
Published: May 2021

We investigate the current LHC bounds on New Physics (NP) that contributes to $${\bar{B}} \rightarrow {D^{(*)}}l{\bar{\nu }}$$

B

¯

→

D

(

∗
)

l

ν

¯

for $$l = (e,\mu ,\tau )$$

l
=
(
e
,
μ
,
τ
)

by considering both leptoquark (LQ) models and an effective-field-theory (EFT) Hamiltonian. Experimental analyses from $$l+\text {missing}$$

l
+
missing

searches with high $$p_T$$

p
T

are applied to evaluate the NP constraints with respect to the Wilson coefficients. A novel point of this work is to show difference between LQs and EFT for the applicable LHC bound. In particular, we find that the EFT description is not valid to search for LQs with the mass less than $$\lesssim 10\,\text {TeV}$$

≲
10

TeV

at the LHC and leads to overestimated bounds. We also discuss future prospects of high luminosity LHC searches including the charge asymmetry of background and signal events. Finally, a combined summary for the flavor and LHC bounds is given, and then we see that in several NP scenarios the LHC constraints are comparable with the flavor ones.
Reconstructing Words from Right-Bounded-Block Words
Authors: Fleischmann Pamela , Lejeune Marie , Manea Florin , Nowotka Dirk , Rigo Michel
Published: May 2021

A reconstruction problem of words from scattered factors asks for the minimal information, like multisets of scattered factors of a given length or the number of occurrences of scattered factors from a given set, necessary to uniquely determine a word. We show that a word [Formula: see text] can be reconstructed from the number of occurrences of at most [Formula: see text] scattered factors of the form [Formula: see text], where [Formula: see text] is the number of occurrences of the letter [Formula: see text] in [Formula: see text]. Moreover, we generalise the result to alphabets of the form [Formula: see text] by showing that at most [Formula: see text] scattered factors suffices to reconstruct [Formula: see text]. Both results improve on the upper bounds known so far. Complexity time bounds on reconstruction algorithms are also considered here.
Construction of ZnxCd1−xS/CeO2 composites for enhanced photocatalytic activity and stability by chemical precipitation method
Authors: Chai Yi-Feng , Zhu Zhong-Hua , Liu Ming-Wei , Zeng Jing , Huang Gui-Fang , Wang Ling-Ling , Huang Wei-Qing
Published: May 2021

Development photoinduced photocatalysts is a significant approach to improve photocatalytic activity and stability. Herein, we successfully prepared [Formula: see text] composites by a facile method. It is found that the [Formula: see text] composites show significant enhancement in photocatalytic activity for methyl orange (MO) degradation under visible and UV light irradiation. The degradation efficiency reaches up to 3.7 times higher than that of pure [Formula: see text] under visible light irradiation. Moreover, the [Formula: see text] samples have almost no loss of photocatalytic activity after five recycles, indicating good photocatalytic stability of the samples. The attractive photocatalytic activity of the [Formula: see text] samples could b e attributed to the robust charge carriers transfer and separation.
MODELING AND OPTIMIZATION OF HOLE ACCURACY AND DRILLING TIME IN MAGNESIUM AZ31 PLATE
Authors: VARATHARAJULU M. , DURAISELVAM MUTHUKANNAN , JAYAPRAKASH G. , BASKAR N. , KARTHICK P. , ANBARASU R.
Published: May 2021

Owing to the advancement in the field of materials, different range of grades have been developed. The machinability examination of these newer grades must be carried out for future applications. One such newer grade of magnesium with AZ31 is deemed for study during the drilling process. The independent parameters considered are spindle speed (SS), feed rate (FR) and drill bit diameter (DBD). The dependent parameters considered are burr height (BH), burr thickness (BT), drilling time (DT) and surface roughness (SR). Improving hole accuracy is essential for manufacturing superior products, which is discussed in this work. At the same time, the machining time has also to be minimized to increase the production rate. With these objectives, the experimental investigation is made. Further, an analytical model for predicting the responses is developed; later, optimization is carried out to obtain the desired responses through the desirability function approach. The multi-objective optimization suggests the SS of 1100[Formula: see text]rpm, the FR of 0.198[Formula: see text]mm/rev., and the DBD of 6[Formula: see text]mm for reducing the entire dependent is reckoned.
Solution of a Class of Nonlocal Elliptic BVPs Arising in Fluid Flow: An Iterative Approach
Authors: Khuri S. A.
Published: May 2021

The ultimate goal of this study is to implement a fixed point iterative scheme for the numerical solution of an extended class of nonlinear, nonlocal, elliptic boundary value problems. The method is based on applying well-known fixed point procedures such as Mann’s and Picard’s to a tailored linear integral that is expressed in terms of a Green’s function. A proof of convergence that utilizes the contraction principle is included. A number of test examples are presented to confirm the applicability, high accuracy and efficacy of the iterative process.
Cytochrome-c aptamer functionalized Pt nanoclusters for enhanced chemodynamic therapy
Authors: Feng Bo , Zhao Dan , Peng Yaowei , Wang Fu
Published: May 2021

Catalysis-based chemodynamic therapy (CDT) is an emerging cancer treatment strategy which uses a Fenton-like reaction to kill tumor cells by catalyzing endogenous hydrogen peroxide (H2O[Formula: see text] into a toxic hydroxyl radical ([Formula: see text]OH). The performance of CDT is greatly dependent on PDT agent. Herein, mitochondria-targeting Pt nanoclusters were synthesized using cytochrome c aptamer (CytcApt) as template. The obtained CytcApt-PtNCs can produce [Formula: see text]OH by H2O2 under the acidic conditions. Moreover, CytcApt-PtNCs could kill 4T1 tumor cells in a pH-dependent manner, but had no side effect on normal 293T cells. Therefore, CytcApt-PtNCs possess excellent therapeutic effect and good biosafety, indicating their great potential for CDT.
REGULARIZATION METHODS FOR ESTIMATING A MULTI-FACTOR CORPORATE BOND PRICING MODEL: AN APPLICATION FOR BRAZIL
Authors: GUIMARÃES PAULO ROBERTO , CANDIDO OSVALDO , RONZANI ANDRÉ
Published: May 2021

The present work focused on studying which factors affect Brazilian inflation-linked corporate bond prices in a primary market setting. The explanatory variables tested were rating, maturity, duration, issuer governance level, industrial classification, collateral, tax exemption, public offering modality, financial volume, coupon frequency, number of issues, number of days since going public, and the Brazilian basic interest rate target. In order to choose the set of variables with best predictive performance, best subsets ordinary least square (OLS) and least absolute shrinkage and selection operator (LASSO) were applied on a testing sample. For estimating purposes, we also tested the Ridge estimator. For both LASSO and Ridge, we used the k-fold approach to choose the optimal value for the lambda penalty. In terms of smallest mean squared error, the OLS estimator outperformed both the Ridge and the LASSO. This result suggests that the variance-bias trade-off might not be a concern for the Brazilian case.
Does SME financing perform well from both demand and supply sides? The case of a developing country
Authors: Ali Md. Rostam , Ahmed Rustom Ali , Tisha Rushafa Tasnim , Islam Md. Ashikul
Published: May 2021

This study provides a way of understanding to analyze the performance of SME credit both from the demand and supply sides. Both primary and secondary data are used which are collected from entrepreneurs of SMEs and the head office of Rajshahi Krishi Unnayan Bank, a leading SME loan providing government-owned agricultural development bank in the Rajshahi district of Bangladesh. Some descriptive statistics, accounting and financial techniques, and a regression model are used to analyze the data. The study finds that the average ROA of SMEs is 35.87% and the ROE of SMEs is 62.81%. It indicates that the SMEs are earning more than the cost of the fund collected from the institutional sources. It is also observed that there is a significant effect of institutional credit on ROE of SMEs but not on ROA. On the other hand, the growth rate of SME NPL is higher than the total NPL during the study years that is of course alarming regarding SME loan recovery. The institutional SME credit should be increased by applying proper strategies for increasing loan recovery performance.
Occupation times of Lévy processes
Authors: Wu Lan , Zhang Xiao
Published: May 2021

In this paper, we give a complete and succinct proof that an explicit formula for the occupation time holds for all Lévy processes, which is important to the pricing problems of various occupation-time-related derivatives such as step options and corridor options. We construct a sequence of Lévy processes converging to a given Lévy process to obtain our conclusion. Besides financial applications, the mathematical results about occupation times of a Lévy process are of interest in applied probability.
Leveraging Control Flow Knowledge in SMT Solving of Program Verification
Authors: Chen Jianhui , He Fei
Published: May 2021

Satisfiability modulo theories (SMT)
solvers have been widely applied as the reasoning engine for diverse software analysis and verification technologies. The efficiency of the SMT solver has significant effects on the performance of these technologies. However, current SMT solvers are designed for the general purpose of constraint solving. Lots of useful knowledge of programs cannot be utilized during SMT solving. As a result, the SMT solver may spend much effort to explore redundant search space. In this article, we propose a novel approach to utilizing control-flow knowledge in SMT solving. With this technique, the search space can be considerably reduced, and the efficiency of SMT solving is observably improved. We conducted extensive experiments on credible benchmarks. The results show significant improvements of our approach.
Revitalizing the public internet by making it extensible
Authors: Balakrishnan Hari , Banerjee Sujata , Cidon Israel , Culler David , Estrin Deborah , Katz-Bassett Ethan , Krishnamurthy Arvind , McCauley Murphy , McKeown Nick , Panda Aurojit , Ratnasamy Sylvia , Rexford Jennifer , Schapira Michael , Shenker Scott , Stoica Ion , Tennenhouse David , Vahdat Amin , Zegura Ellen
Published: May 2021

There is now a significant and growing functional gap between the public Internet, whose basic architecture has remained unchanged for several decades, and a new generation of more sophisticated private networks. To address this increasing divergence of functionality and overcome the Internet's architectural stagnation, we argue for the creation of an Extensible Internet (EI) that supports in-network services that go beyond best-effort packet delivery. To gain experience with this approach, we hope to soon deploy both an experimental version (for researchers) and a prototype version (for early adopters) of EI. In the longer term, making the Internet extensible will require a community to initiate and oversee the effort; this paper is the first step in creating such a community.
Simultaneous Electrochemical Quantification of Foodstuff Dyes Allura Red and Tartrazine Using a Bare Carbon Paste Electrode
Authors: Rivera-Hernández S. I. , Corona-Avendaño S. , Vázquez-Huerta G. , Palomar-Pardavé M. , Romero-Romo M. , Ramírez-Silva M. T.
Published: May 2021

A bare carbon paste electrode, BCPE, was used to determine simultaneously the foodstuff dyes Allura Red (AR) and Tartrazine (Trz) in aqueous media, achieving the following analytical parameters: for AR sensitivity of (0.126 ± 0.002)μA (mg l)−1with a limit of detection (LOD) of (0.14 ± 0.004) mg l−1and a Trz sensitivity of (0.392 ± 0.024)μA (mg l)−1with a LOD of (0.310 ± 0.034) mg l−1. Additionally, the individual and simultaneous quantifications of AR and Trz in real samples, were performed through the electrochemical method proposed in this work. In the case of individual dyes quantification, the results were like those found using UV–vis spectrophotometry, however, contrary to the electrochemical method proposed in this work, the spectrophotometric method cannot be used for the simultaneous quantifications due to the dyes absorbance overlap. Furthermore, the BCPE is a robust electrode that, contrary to other modified CPE reported for this purpose, can be reused for multiple quantifications by simple mechanical polishing of its electroactive surface, beside its excellent reproducibility, accuracy, and lifetime. Usually the dyes are found in concentrations of mg l−1in foodstuffs, which makes this electrode suitable for use in foods and non-alcoholic beverages.