bluuebunny/crossref_metadata_2025 huggingface dataset:
Distribution of triggers foci and outcomes of catheter ablation in atrial fibrillation patients in different age groups
Authors: Lin Chung‐Hsing , Chang Shih‐Lin , Lin Yenn‐Jiang , Lo Li‐Wei , Hu Yu‐Feng , Chung Fa‐Po , Chao Tze‐Fan , Lin Chin‐Yu , Tuan Ta‐Chuan , Liao Jo‐Nan , Kuo Ling , Chang Ting‐Yung , Li Hsing‐Yuan , Huang Ting‐Chung , Chuang Chieh‐Mao , Vicera Jennifer Jeanne , Chen Shih‐Ann
Published: August 2021

Background

Atrial fibrillation (AF) prevalence increases with age. Aging affects the substrate properties of the left atrium (LA) and the outcomes of catheter ablation for treating AF. We investigated the AF trigger distribution and catheter ablation outcomes in patients of different ages with AF.

Methods

1585 patients with AF (1181 paroxysmal and 404 non‐ paroxysmal AF) who had undergone catheter ablation were enrolled. The patients were divided into young (20–40 year‐old, n = 175), middle‐aged (41–64 year‐old, n = 1134), and old (≥ 65 year‐old, n = 276) groups. Electrophysiological characteristics and AF trigger sites were recorded.

Result

The incidence of AF with only non‐pulmonary vein (non‐PV) foci was higher in the young group than in the other groups (8.6% vs. 3.6% vs. 3.3%, p < 0.01). Non‐PV foci were more commonly located in the superior vena cava (SVC) in the young group than in the other groups (13.1% vs. 7.8% vs. 6.5%, p = 0.03). The left atrium (LA) mean voltage was higher and the incidence of very late recurrence after AF ablation was lower in the young group than in the other groups. However, the final AF recurrence rate after multiple procedures and complication rates were similar among all the groups at a mean follow‐up of 5.6 years.

Conclusion

The young patients with AF had a higher incidence of only non‐PV foci, mostly located in SVC, than the middle‐aged and old patients. Our study highlights the importance of identifying the non‐PV foci in catheter ablation of young patients with AF.
Herbivore‐induced volatiles influence moth preference by increasing the β‐Ocimene emission of neighbouring tea plants
Authors: Jing Tingting , Qian Xiaona , Du Wenkai , Gao Ting , Li Dongfeng , Guo Danyang , He Fan , Yu Guomeng , Li Shupeng , Schwab Wilfried , Wan Xiaochun , Sun Xiaoling , Song Chuankui
Published: August 2021

Herbivore‐induced plant volatiles prime neighbouring plants to respond more strongly to subsequent attacks. However, the key volatiles that trigger this state and their priming mechanisms remain largely unknown. The tea geometrid Ectropis obliqua is one of the most devastating leaf‐feeding pests of tea plants. Here, plant–plant communication experiments demonstrated that volatiles emitted from tea plants infested by E. obliqua larvae triggered neighbouring plants to release volatiles that repel E. obliqua adult, especially mated females. Volatile analyses revealed that the quantity of eight volatiles increased dramatically when plants were exposed to volatiles emitted by infested tea plants, including (Z)‐3‐hexenol, linalool, α‐farnesene, β‐Ocimene and (E)‐4,8‐dimethyl‐1,3,7‐nonatriene (DMNT). The results of behavioural bioassays demonstrated that β‐Ocimene strongly repelled mated E. obliqua females. Individual volatile compound exposure experiments revealed that (Z)‐3‐hexenol, linalool, α‐farnesene and DMNT triggered the emission of β‐Ocimene from tea plants. Chemical inhibition experiments demonstrated that the emission of β‐Ocimene induced by (Z)‐3‐hexenol, linalool, α‐farnesene and DMNT were dependent on Ca2+ and JA signalling. These findings help us to understand how E. obliqua moths respond to volatiles emitted from tea plants and provide new insight into volatile‐mediated plant–plant interactions. They have potential significance for the development of novel insect and pest control strategies in crops.
Effect of retinol as antioxidant on the post‐thaw viability and the expression of apoptosis and developmental competence‐related genes of vitrified preantral follicles in buffalo (Bubalus bubalis)
Authors: Gupta PSP , Johnson P , Kaushik K , Krishna K , Nandi S , Mondal S , Nikhil Kumar Tej J , Somoskoi B , Cseh S
Published: August 2021

The present study evaluated the effect of supplementation of retinol in the vitrification solution on the viability, apoptosis and development‐related gene expression in vitrified buffalo preantral follicles. Preantral follicles isolated from cortical slices of ovaries were randomly assigned into three groups: Group1—Control fresh preantral follicles; Group 2—Vitrification treatment (Vitrification solution 1 (VS1) –TCM‐199 + 25 mM HEPES + Foetal bovine serum (FBS) 10%, Ethylene glycol (EG): 10%, Dimethyl sulphoxide (DMSO): 10%, Sucrose‐0.3 M for 4 min; VS2‐ TCM‐199 + 25 mM HEPES + FBS10%, EG:25%, DMSO: 25%, Sucrose:0.3 M for 45 s); Group3—vitrification treatment +5 μM of Retinol. Preantral follicles were placed in corresponding vitrification medium and plunged into liquid nitrogen (−196°C). After a week, the follicles were thawed and analysed for follicular viability and gene expression. There was no significant difference in the viability rates among the Group 1(Fresh preantral follicles) (91.46 ± 2.39%), Group 2 (89.59 ± 2.46%) and Group 3 (87.19 ± 4.05%). There was a significantly (p < .05) higher mRNA expression of BCL2L1, GDF‐9 and BMP‐15 in the vitrification + retinol group compared with the control group. There was a significantly (p < .05) higher expression of Caspase‐3 and Annexin‐5 in the vitrification group and Vitrification + retinol group compared with control group of follicles. It is concluded that the supplementation of 5 μM of Retinol in Vitrification solution was an efficient vitrification procedure for the vitrification of buffalo preantral follicles.
Plant performance predicted by genetic variation and environmental distance in important restoration shrub species Cercocarpus montanus
Authors: Crow Taylor M. , Hufford Kristina M. , Burney Owen T.
Published: August 2021

Seed transfer guidelines are used to guide the human‐mediated movement of plant propagules from collection to recipient sites and are designed to minimize the risk of introducing maladapted genotypes. The spatial scale of adaptation, however, is unknown for most species, making it difficult to assess the potential negative impacts of seed transfer. In this study, we generated seed transfer guidelines for an ecologically important shrub, alder‐leaf mountain mahogany (Cercocarpus montanus). We plant material from 24 populations of C. montanus along a latitudinal transect from the southern Rocky Mountains of New Mexico, Colorado, and Wyoming. Seeds and seedlings were sown and planted separately in common garden experimental sites representing dissimilar environments. We measured plant germination, survival, growth, and leaf morphology for three growing seasons, and found significant variation among populations. Environmental and genetic distance were useful predictors of population performance in our common garden trials, which we use to recommend broad‐scale seed transfer guidelines to minimize risk of maladaptation to restoration sites.
Suspected hemolytic anemia secondary to acute zinc toxicity after ingestion of “max strength” (zinc oxide) diaper rash cream
Authors: Ambar Neta , Tovar Tricia
Published: August 2021

Objective

To describe the clinical presentation of a dog with hemolytic anemia secondary to zinc toxicosis after 1‐week use of “max strength” 40% diaper rash cream.

Case Summary

A 2‐year‐old female neutered Maltese presented for vomiting, lethargy, pigmenturia, and pale mucous membranes. “Max Strength” zinc oxide cream had been applied to the patient daily for a week prior to presentation. Clinical examination revealed light pink to pale mucous membranes and tachycardia. Hematology demonstrated large numbers of spherocytes and a strongly regenerative anemia. Plasma zinc concentrations were markedly increased. A diagnosis of hemolytic anemia secondary to subacute zinc toxicosis was made and supportive therapy was instigated. The patient ultimately recovered uneventfully. Acute or subacute zinc toxicosis resulting in hemolytic anemia is not frequently observed, and this case was also unusual in that the zinc source was diaper cream, which historically has been thought to require very large quantities to cause toxicosis.

New or Unique Information Provided

To the authors’ knowledge, there is only one previously reported case of hemolytic anemia secondary to diaper cream use in a hospital setting but no previous reports involving toxicosis secondary to prolonged application at home by owners. Most commercial diaper creams contain zinc oxide, which historically was thought to have poor gastrointestinal absorption and would require a large quantity to cause significant toxicosis and hemolytic anemia. Moreover, this case emphasizes the potential risks associated with zinc oxide cream use, the significance of client education if using these creams, as well as the importance of history in elucidating the underlying cause of hemolytic anemia.
Machine learning model development for quantitative analysis of CT heterogeneity in canine hepatic masses may predict histologic malignancy
Authors: Shaker Rami , Wilke Christopher , Ober Christopher , Lawrence Jessica
Published: August 2021

Tumor heterogeneity is a well‐established marker of biologically aggressive neoplastic processes and is associated with local recurrence and distant metastasis. Quantitative analysis of CT textural features is an indirect measure of tumor heterogeneity and therefore may help predict malignant disease. The purpose of this retrospective, secondary analysis study was to quantitatively evaluate CT heterogeneity in dogs with histologically confirmed liver masses to build a predictive model for malignancy. Forty dogs with liver tumors and corresponding histopathologic evaluation from a previous prospective study were included. Triphasic image acquisition was standardized across dogs and whole liver and liver mass were contoured on each precontrast and delayed postcontrast dataset. First‐order and second‐order indices were extracted from contoured regions. Univariate analysis identified potentially significant indices that were subsequently used for top‐down model construction. Multiple quadratic discriminatory models were constructed and tested, including individual models using both postcontrast and precontrast whole liver or liver mass volumes. The best performing model utilized the CT features voxel volume and uniformity from postcontrast mass contours; this model had an accuracy of 0.90, sensitivity of 0.67, specificity of 1.0, positive predictive value of 1.0, negative predictive value of 0.88, and precision of 1.0. Heterogeneity indices extracted from delayed postcontrast CT hepatic mass contours were more informative about tumor type compared to indices from whole liver contours, or from precontrast hepatic mass and whole liver contours. Results demonstrate that CT radiomic feature analysis may hold clinical utility as a noninvasive method of predicting hepatic malignancy and may influence diagnostic or therapeutic approaches.
Flamelet Versus Detailed Chemistry Large Eddy Simulation for a Liquid-Fueled Gas Turbine Combustor: A Comparison of Accuracy and Computational Cost
Authors: Karalus Megan , Thakre Piyush , Goldin Graham , Brandt Dustin
Published: August 2021

A Honeywell liquid-fueled gas turbine test combustor at idle conditions is numerically investigated in simcenterstar-ccm+ version 2020.3. This work presents large eddy simulation (LES) results using both the flamelet generated manifold (FGM) and detailed chemistry combustion models. Both take advantage of a hybrid chemical (HyChem) mechanism which has previously demonstrated very good accuracy for real fuels such as Jet-A with only 47 species. The objective of this work is to investigate the ability of FGM and detailed chemistry modeling to capture pollutant formation in an aero-engine combustor. Comparisons for NOx, CO, unburned hydrocarbons (UHC), and soot are made, along with the radial temperature profile. To fully capture potential emissions, a soot moment model and Zeldovich NOx model are employed along with radiation. A comparison of results with and without chemistry acceleration techniques for detailed chemistry is included. Then, computational costs are assessed by comparing the performance and scalability of the simulations with each of the combustion models. It is found that the detailed chemistry case with clustering can reproduce nearly identical results to detailed chemistry without any acceleration if CO is added as a clustering variable. With the Lagrangian model settings chosen for this study, the detailed chemistry results compared more favorably with the experimental data than FGM; however, there is uncertainty in the secondary breakup parameters. Sensitivity of the results to a key parameter in the spray breakup model is provided for both FGM and complex chemistry (CC). By varying this breakup rate, the FGM case can predict CO, NOx, and UHC equally well. The smoke number, however, is predicted most accurately by CC. The cost for running detailed chemistry with clustering is found to be about four times that of FGM for this combustor and chemical mechanism.
Revolutionary Vertical Lift Technology Side-by-Side Hybrid Concept Vehicle Powertrain Dynamic Model
Authors: Bianco Santino J. , Chevalier Christine T. , Litt Jonathan S. , Smith Joshua K. , Chapman Jeffryes W. , Kratz Jonathan L.
Published: August 2021

The side-by-side (SBS) hybrid is one of several Revolutionary Vertical Lift Technology (RVLT) concept aircraft identified by the National Aeronautics and Space Administration (NASA) to investigate Urban Air Mobility (UAM) requirements. This paper presents a dynamic model of the SBS hybrid powertrain built using the toolboxforthemodelingandanalysisofthermodynamicsystems (t-mats) and the electricalmodelingandthermalanalysistoolbox (emtat). The model consists of the rotors, electrical power system, and turboshaft engines connected through freewheeling clutches, gearboxes, and multiple shafts. This research effort models the complex behavior of the powertrain, including the operation of the freewheeling clutches and electrical power system at the simulation time scale of the shaft dynamics. Several simulations highlight the key features present in the model and demonstrate its operation.
An Extrema Approach to Probabilistic Creep Modeling in Finite Element Analysis
Authors: Hossain Md Abir , Cottingham Jacqueline R. , Stewart Calvin M.
Published: August 2021

This paper introduces a computationally efficient extrema approach for the probabilistic predictions of creep in finite element analysis (FEA). Component-level probabilistic simulations are needed to assess the reliability and safety of high-temperature components. Full-scale probabilistic creep models in FEA are computationally expensive, requiring many hundreds of simulations to replicate the uncertainty of component failure. Extrema are conditions at which the values of a function are the largest or the smallest. In this study, an extrema approach is proposed. In the extrema approach, full-scale probabilistic simulations are completed in one-dimensional across a wide range of stresses, the results are processed, and extrema conditions are extracted. The extrema conditions alone are applied in two-/three-dimensional FEA to predict the mean and range of creep failure. The probabilistic Sinh model, calibrated for alloy 304 stainless steel, is selected. The sources of uncertainty (i.e., test condition, pre-existing damage, and model constants) are evaluated and probability distribution functions sampling are performed via Monte Carlo method. The extrema conditions considered include the range of creep ductility, rupture, and area under creep curves. The predicted creep response for one- and two-dimensional model shows agreement with the experimental data. It is determined that extrema approach will significantly reduce the computational cost of probabilistic creep predictions in FEA.
Turbine Inlet Temperature Measurements in an 8200 KW Gas Turbine Using Water Vapor Emission
Authors: Tree Dale R. , Badger Dustin , Zeltner Darrel , Rezasoltani Mohsen
Published: August 2021

The measurement of turbine inlet temperature is challenging because of high temperatures and complicated physical access, but continuous measurement of the turbine inlet temperature is very important for maximizing turbine efficiency and increasing durability. This paper provides in situ turbine rotor inlet temperature measurements in an 8200 kW operating gas turbine engine. The measurements were obtained using integrated spectral infrared emission from the water vapor of the combustion gases entering the turbine rotor. The method utilizes a sapphire optical fiber to convey the signal from the turbine wall to outside the turbine casing. All components are capable of long-term exposure to the turbine operating conditions. The temperature measurements were obtained at 6 operating conditions between 50% and full load. The turbine rotor inlet temperature temperature was also determined using more than 20 test cell inputs and Solar Turbine's commercial test cell engine model. The two temperatures (measured and modeled) were within 11 K (less than 1%) across the load sweep. Uncertainty calculations suggest that the uncertainty of the measurement can be expected to be ±2.9% within a confidence interval of 95%. The method also yields the nozzle guide vane surface temperature, which was found to increase monotonically with increasing load.
Characterization of a Newly Designed Test Bench for Investigations of Flame–Wall Interaction
Authors: Dalshad Rahand , Sander Tobias , Pfitzner Michael
Published: August 2021

For the thermal design of combustion chambers and turbine blades in jet engines, a detailed knowledge of the combustion and of the heat loads to the walls is necessary. In general, high operating temperatures and reduced combustor size are striven for in order to increase engine efficiency and reduce weight. Consequently, the components are exposed to temperatures above the melting point of the materials and there is a growing risk of incomplete combustion within the combustion chambers. To study these effects, we setup a new test bench for fundamental investigation of chemical near-wall reactions at atmospheric pressure. First results of gaseous, nonpremixed near-wall CH4/air and H2/air flames are presented. Optical methods such as two-line laser-induced fluorescence thermometry and OH* chemiluminescence were applied. Further, the heat release to the wall was determined by means of inverse heat conduction calculation using the data of implemented thermocouples.
Measurements to Quantify the Effect of a Reduced Flow Rate on the Performance of a Tilting Pad Journal Bearing With Flooded Ends
Authors: San Andrés Luis , Toner Jonathan , Alcantar Andy
Published: August 2021

Operation of tilting pad journal bearings (TPJBs) with a reduced flow decreases pumping costs and oil sump storage. A low supplied oil flow improves system energy efficiency by reducing drag power losses, albeit the temperature rise in both the bearing pads and the lubricating oil become a concern. This paper presents measurements of the static and dynamic load performance of a flooded ends TPJB lubricated with an ISO VG 46 oil supplied at 60 °C, and with a flow rate ranging from 150% to just ∼5% of a nominal supply condition. The flow range covers both over-flooded and starved flow conditions. The test bearing is a four-pad, 102 mm diameter, center pivot, with single orifice feeds, and configured with end seals to flood the bearing housing. The experiments include operation at two shaft speeds = 6 krpm and 12 krpm (= 64 m/s surface speed) and under three specific loads = 0.345 MPa, 1.03 MPa, and 2.07 MPa applied in between pads (LBP). The measurements show the bearing drag power loss decreases by nearly 20% when the flow rate drops to 50% of nominal. However, halving the flow produces a raise in pad subsurface temperatures, ∼7 °C for operation at 12 krpm. Flow reduction below 50% does result in even more substantial power savings; however, it also produces too hot pad temperatures that approach 130 °C, a known limit for Babbitt material safe operation. The bearing static eccentricity (e) and direct stiffnesses Kxx < Kyy (load direction) do not show a significant dependency on the supplied flow, either above or below the nominal condition. A minor stiffness hardening does occur for very low flow conditions, 5% or so of nominal. Damping coefficients (Cxx ∼ Cyy) decrease by ∼30% as the flow rate decreases from 150% to just a few % of the nominal flow. The experimental results are first to quantify the operation of a TPJB supplied with minute amounts of lubricant flow. A test with a very low flow rate at ∼2% of nominal and under a light load produced the emergence of a broadband subsynchronous vibration (SSV) frequency, albeit with a very small amplitude.
An Exploratory Assessment of Sociocultural Attitudes and Appearance Comparison Among Athletes With Physical Disabilities
Authors: Rodriguez Alexandra M. , Ede Alison , Madrigal Leilani , Vargas Tiffanye , Greenleaf Christy
Published: August 2021

This study aimed to assess the internalization of sociocultural attitudes and appearance comparison among U.S. athletes with physical disabilities. Female (n = 19) and male (n = 25) athletes between the ages of 18 and 73 years completed a quantitative survey along with two exploratory open-ended questions related to body appearance and influencers. Results showed significant correlations between internalization of the thin and low-body-fat ideal and appearance comparison (r = .55, p < .05) and internalization of the muscular ideal and appearance comparison (r = .76, p < .05) among women. For men, results showed a significant association between internalization of the muscular ideal and appearance comparison (r = .52, p < .05). The findings prompt further investigation of whether appearance comparison and internalization influence body dissatisfaction and disordered eating among athletes with physical disabilities.
Para Sport Development Experiences: Perspectives of Para Swimmers and Parents
Authors: Sales Darda , Misener Laura
Published: August 2021

This study examined para swimmers’ athlete development experiences from the perspectives and reflections of athletes, and parents of athletes, with a focus on the constraints and challenges experienced. Guided by interpretive phenomenological analysis, 12 participants engaged in the interview process (seven parents and five athletes). Five themes were identified: fundamental skill development, personal connection, coaching, classification, and connecting with others “like me.” Through a discussion of the differences in development experiences between the participants in this study and the current literature on athlete development, the authors highlight areas of concern in applying a non-para-specific athlete development model to para swimmers. This study identifies several areas of consideration in the future design of a para athlete development framework or model.
We Love You, We Hate You: Fan Twitter Response to Top College Football Recruits’ Decisions
Authors: Stamm Jason , Boatwright Brandon
Published: August 2021

Using a theoretical underpinning of parasocial interaction—BIRGing (basking in reflected glory) and CORFing (cutting off reflected failure)—this study explored fan reactions to high school athletes’ commitments to play football for National Collegiate Athletic Association Division I programs. A thematic analysis of tweets made by fans during the 2020 recruiting period was examined in two stages: (a) tweets directed toward recruits before they committed to a program and (b) tweets directed toward recruits after they committed. Findings show fan frivolity in regard to identification, as well as a desire to become part of the recruiting process of high school football players. In addition, results yield the possibility of a shift in athlete motivations for social media use, fan association with athletics programs, and how fans cope with unexpected loss. Theoretical and practical implications are further discussed.
Carbohydrate and Protein Co-Ingestion Postexercise Does Not Improve Next-Day Performance in Trained Cyclists
Authors: Kontro Hilkka , Kozior Marta , Whelehan Gráinne , Amigo-Benavent Miryam , Norton Catherine , Carson Brian P. , Jakeman Phil
Published: August 2021

Supplementing postexercise carbohydrate (CHO) intake with protein has been suggested to enhance recovery from endurance exercise. The aim of this study was to investigate whether adding protein to the recovery drink can improve 24-hr recovery when CHO intake is suboptimal. In a double-blind crossover design, 12 trained men performed three 2-day trials consisting of constant-load exercise to reduce glycogen on Day 1, followed by ingestion of a CHO drink (1.2 g·kg−1·2 hr−1) either without or with added whey protein concentrate (CHO + PRO) or whey protein hydrolysate (CHO + PROH) (0.3 g·kg−1·2 hr−1). Arterialized blood glucose and insulin responses were analyzed for 2 hr postingestion. Time-trial performance was measured the next day after another bout of glycogen-reducing exercise. The 30-min time-trial performance did not differ between the three trials (M ± SD, 401 ± 75, 411 ± 80, 404 ± 58 kJ in CHO, CHO + PRO, and CHO + PROH, respectively, p = .83). No significant differences were found in glucose disposal (area under the curve [AUC]) between the postexercise conditions (364 ± 107, 341 ± 76, and 330 ± 147, mmol·L−1·2 hr−1, respectively). Insulin AUC was lower in CHO (18.1 ± 7.7 nmol·L−1·2 hr−1) compared with CHO + PRO and CHO + PROH (24.6 ± 12.4 vs. 24.5 ± 10.6, p = .036 and .015). No difference in insulin AUC was found between CHO + PRO and CHO + PROH. Despite a higher acute insulin response, adding protein to a CHO-based recovery drink after a prolonged, high-intensity exercise bout did not change next-day exercise capacity when overall 24-hr macronutrient and caloric intake was controlled.
Sitting Time, Physical Activity, and Cognitive Impairment in Midlife and Older Adults
Authors: Gafni Tal , Shuval Kerem , Weinstein Galit , Barlow Carolyn E. , Gabriel Kelley Pettee , Willis Benjamin L. , Leonard David , Haskell William L. , DeFina Laura F.
Published: August 2021

This study cross-sectionally examines the relations of sitting and physical activity (PA) with cognitive impairment in community-dwelling adults aged 55–87 years (n = 3,780). Multivariable logistic regression assessed independent and joint relations of sitting and PA with Montreal Cognitive Assessment scores adjusting for covariates. Sitting ≥75% of the time and not meeting PA guidelines were related to 60% (95% confidence interval [CI] [1.19, 2.17]) and 27% (95% CI [1.06, 1.53]) higher odds for cognitive impairment, respectively. Stratification by age showed that sitting ≥75% of the time was associated with higher cognitive impairment odds in midlife (odds ratio [OR] = 1.86; 95% CI [1.31, 2.65]), but not older adults (OR = 1.06; 95% CI [0.57, 1.95]). Joint association analysis revealed that, overall, the highest odds for cognitive impairment were in those sitting ≥75% of the time while meeting or not meeting PA guidelines (OR = 1.69, 95% CI [1.13, 2.53]; and OR = 1.66, 95% CI [1.19, 2.32], respectively). In conclusion, prolonged sitting and insufficient PA are independent risk markers for cognitive impairment.
Exercise and Cardioprotection in Coronary Artery Disease: A Pilot Quasi-Experimental Study
Authors: Thompson Gareth , Davison Gareth W. , Crawford Jacqui , Hughes Ciara M.
Published: August 2021

Sirtuin-1 is a protein that may orchestrate the cardioprotective effect of exercise by controlling cellular processes. This pilot study assessed the feasibility of performing a quasi-experimental study in this area. Patients with postacute myocardial infarction were recruited across four hospital sites in the United Kingdom. The participants were offered one weekly exercise session at Phase-III and Phase-IV cardiac rehabilitation (CR). Measurements were obtained pre-Phase-III CR (Week 1), post-Phase-III CR (Week 8), and post-Phase-IV CR (Week 22). Twenty-eight patients were recruited (79% male, 100% White, 60.2 ± 10.5 years old). The recruitment rate was not fulfilled (<70% eligible patients recruited; 0.9 participants recruited per week over 30 weeks). The success criteria for dropout rate, adherence rate, and collection of sirtuin-1 measures were satisfied. A large increase in sirtuin-1 (0.14 ± 0.03,d≥ 0.8) was seen after Phase-III and Phase-IV CR. Collectively, a quasi-experimental study is feasible with a revised recruitment strategy.
Associations Between Physical and Executive Functions Among Community-Dwelling Older Men and Women
Authors: Tirkkonen Anna , Kulmala Jenni , Hänninen Tuomo , Törmäkangas Timo , Stigsdotter Neely Anna , Sipilä Sarianna
Published: August 2021

Walking is a complex task requiring the interplay of neuromuscular, sensory, and cognitive functions. Owing to the age-related decline in cognitive and physical functions, walking may be compromised in older adults, for cognitive functions, especially poor performance in executive functions, is associated with slow walking speed. Hence, the aim of this study was to investigate the associations between different subdomains of executive functions and physical functions and whether the associations found differ between men and women. Multiple linear regression analysis was performed on data collected from 314 community-dwelling older adults who did not meet physical activity guidelines but had intact cognition. Our results showed that, while executive functions were associated with gait and lower extremity functioning, the associations depended partly on the executive process measured and the nature of the physical task. Moreover, the associations did not differ between the sexes.
Associations of Mutually Exclusive Categories of Physical Activity and Sedentary Time With Metabolic Syndrome in Older Adults: An Isotemporal Substitution Approach
Authors: De la Cámara Miguel A. , Pardos-Sevilla Ana I. , Jiménez-Fuente Augusto , Hubler-Figueiró Thamara , d’Orsi Eleonora , Rech Cassiano Ricardo
Published: August 2021

The aim of this study was to examine, theoretically, how reallocating time between the intensity of mutually exclusive categories of physical activity and sedentary behavior time is associated with metabolic syndrome. Four hundred and six older adults (61.6% women) from the second wave of the EpiFloripa Aging Cohort Study were included in the study (mean age 71.7 ± 5.9 years). Isotemporal substitution analysis showed a decrease of 35% (odds ratio: 0.65; 95% confidence interval [0.45, 0.96]) in the risk for metabolic syndrome when replacing 30 min/day of sedentary behavior with an equivalent amount of moderate to vigorous physical activity. Furthermore, it has been observed that older adults classified as low sedentary behavior and physically active were 57% less likely to have metabolic syndrome than participants classified as high sedentary and physically inactive (odds ratio: 0.43; 95% confidence interval [0.19, 0.97]). This study highlights the importance of behavioral categories that may emerge concerning the interrelationships of physical activity and health in older adults, having important implications for future health intervention programs.
Histone citrullination by PADI4 is required for HIF-dependent transcriptional responses to hypoxia and tumor vascularization
Authors: Wang Yufeng , Lyu Yajing , Tu Kangsheng , Xu Qiuran , Yang Yongkang , Salman Shaima , Le Nguyet , Lu Haiquan , Chen Chelsey , Zhu Yayun , Wang Ru , Liu Qingguang , Semenza Gregg L.
Published: August 2021

Histone citrullination by PADI4 is required for hypoxia-induced gene expression.
Environmental vulnerability of the global ocean epipelagic plankton community interactome
Authors: Chaffron Samuel , Delage Erwan , Budinich Marko , Vintache Damien , Henry Nicolas , Nef Charlotte , Ardyna Mathieu , Zayed Ahmed A. , Junger Pedro C. , Galand Pierre E. , Lovejoy Connie , Murray Alison E. , Sarmento Hugo ,   Tara Oceans coordinators, Acinas Silvia G. , Babin Marcel , Iudicone Daniele , Jaillon Olivier , Karsenti Eric , Wincker Patrick , Karp-Boss Lee , Sullivan Matthew B. , Bowler Chris , de Vargas Colomban , Eveillard Damien
Published: August 2021

A global photic-ocean plankton ecological network predicts distinct vulnerabilities to environmental change across marine biomes.
An epigenetic basis of inbreeding depression in maize
Authors: Han Tongwen , Wang Fang , Song Qingxin , Ye Wenxue , Liu Tieshan , Wang Liming , Chen Z. Jeffrey
Published: August 2021

Inbreeding depression is linked to persistent epigenetic and gene expression changes, which are reversible by random mating.
Structure of the phosphoinositide 3-kinase (PI3K) p110γ-p101 complex reveals molecular mechanism of GPCR activation
Authors: Rathinaswamy Manoj K. , Dalwadi Udit , Fleming Kaelin D. , Adams Carson , Stariha Jordan T. B. , Pardon Els , Baek Minkyung , Vadas Oscar , DiMaio Frank , Steyaert Jan , Hansen Scott D. , Yip Calvin K. , Burke John E.
Published: August 2021

The structure of class IB PI3K (p110γ-p101) reveals mechanism of GPCR activation and differences from class IA PI3Ks.
Apolipoprotein E receptor 2 deficiency decreases endothelial adhesion of monocytes and protects against autoimmune encephalomyelitis
Authors: Calvier Laurent , Manouchehri Navid , Sacharidou Anastasia , Mineo Chieko , Shaul Philip W. , Hui David Y. , Kounnas Maria Z. , Stüve Olaf , Herz Joachim
Published: August 2021

Loss of ApoER2 reduces endothelial adhesion and monocyte extravasation, thereby reducing neuroinflammation, paralysis, and mortality.
A cluster randomised trial of cookstove interventions to improve infant health in Ghana
Authors: Jack Darby W , Ae-Ngibise Kenneth Ayuurebobi , Gould Carlos F , Boamah-Kaali Ellen , Lee Alison G , Mujtaba Mohammed Nuhu , Chillrud Steven , Kaali Seyram , Quinn Ashlinn K , Gyaase Stephaney , Oppong Felix Boakye , Carrión Daniel , Agyei Oscar , Burkhart Katrin , Ana-aro Joseph A , Liu Xinhua , Berko Yvonne Afrah , Wylie Blair J , Etego Seeba Amenga , Whyatt Robin , Owusu-Agyei Seth , Kinney Patrick , Asante Kwaku Poku
Published: August 2021

Introduction

Household air pollution from solid fuel combustion for cooking and heating is a leading cause of childhood morbidity and mortality worldwide. We hypothesised that clean cooking interventions delivered during pregnancy would improve child health.

Methods

We conducted a cluster randomised trial in rural Ghana to test whether providing pregnant women liquefied petroleum gas (LPG) cookstoves or improved biomass cookstoves would reduce personal carbon monoxide and fine particulate pollution exposure, increase birth weight and reduce physician-assessed severe pneumonia in the first 12 months of life, compared with control participants who continued to cook with traditional stoves. Primary analyses were intention-to-treat. The trial was registered with ClinicalTrials.gov and follow-up is complete.

Results

Enrolment began on 14 April 2014, and ended on 20 August 2015. We enrolled 1414 pregnant women; 361 in the LPG arm, 527 in the improved biomass cookstove arm and 526 controls. We saw no improvement in birth weight (the difference in mean birth weight for LPG arm births was 29 g lighter (95% CI −113 to 56, p=0.51) and for improved biomass arm births was 9 g heavier (95% CI −64 to 82, p=0.81), compared with control newborns) nor severe child pneumonia (the rate ratio for pneumonia in the LPG arm was 0.98 (95% CI 0.58 to 1.70; p=0.95) and for the improved biomass arm was 1.21 (95% CI 0.78 to 1.90; p=0.52), compared with the control arm). Air pollution exposures in the LPG arm remained above WHO health-based targets (LPG median particulate matter less than 2.5 microns in diameter (PM2.5) 45 µg/m³; IQR 32–65 vs control median PM2.567 µg/m³, IQR 46–97).

Conclusions

Neither prenatally-introduced LPG nor improved biomass cookstoves improved birth weight or reduced severe pneumonia risk in the first 12 months of life. We hypothesise that this is due to lower-than-expected exposure reductions in the intervention arms.

Trial registration number

NCT01335490.
Phase 3 randomised trial of eltrombopag versus standard first-line pharmacological management for newly diagnosed immune thrombocytopaenia (ITP) in children: study protocol
Authors: Shimano Kristin A , Grace Rachael F , Despotovic Jenny M , Neufeld Ellis J , Klaassen Robert J , Bennett Carolyn M , Ma Clement , London Wendy B , Neunert Cindy
Published: August 2021

Introduction

Immune thrombocytopaenia (ITP) is an acquired disorder of low platelets and risk of bleeding. Although many children can be observed until spontaneous remission, others require treatment due to bleeding or impact on health-related quality of life. Standard first-line therapies for those who need intervention include corticosteroids, intravenous immunoglobulin and anti-D globulin, though response to these agents may be only transient. Eltrombopag is an oral thrombopoietin receptor agonist approved for children with chronic ITP who have had an insufficient response to corticosteroids, intravenous immunoglobulin or splenectomy. This protocol paper describes an ongoing open-label, randomised trial comparing eltrombopag to standard first-line management in children with newly diagnosed ITP.

Methods and analysis

Randomised treatment assignment is 2:1 for eltrombopag versus standard first-line management and is stratified by age and by prior treatment. The primary endpoint of the study is platelet response, defined as ≥3 of 4 weeks with platelets >50×109/L during weeks 6–12 of therapy. Secondary outcomes include number of rescue therapies needed during the first 12 weeks, proportion of patients who do not need ongoing treatment at 12 weeks and 6 months, proportion of patients with a treatment response at 1 year, and number of second-line therapies used in weeks 13–52, as well as changes in regulatory T cells, iron studies, bleeding, health-related quality of life and fatigue. A planned sample size of up to 162 randomised paediatric patients will be enrolled over 2 years at 20 sites.

Ethics and dissemination

The study has been approved by the centralised Baylor University Institutional Review Board. The results are expected to be published in 2023.

Trial registration number

NCT03939637.
Incidence and immediate consequences of electrical shocks among Danish electricians: a cohort study
Authors: Biering Karin , Kærgaard Anette , Carstensen Ole , Nielsen Kent Jacob
Published: August 2021

Objectives

The health-related consequences of electrical shocks are mostly studied in patients from selected cohorts in hospital burn units, by making internal comparisons of subgroups, but without comparing them to unexposed individuals, or considering information regarding the preinjury health of the injured persons. Often, little is known about the details of the electrical shocks. Our purpose was to do a longitudinal study of Danish electrical workers, to monitor exposure to electrical shocks weekly over a 6-month period and to determine whether these shocks have short-term, health-related consequences.

Design

Prospective cohort study with weekly measurements.

Setting

Members of the Danish Union of Electricians.

Participants

Of the 22 284 invited, 6960 electricians (31%) participated in the baseline data collection, and the participation rate in the weekly follow-up ranged from 61% to 81% during the 6 month follow-up.

Primary and secondary outcome measures

The primary outcome measure was an electrical shock and secondary outcomes were the immediate health-related consequences of the shocks.

Results

A total of 2356 electrical shocks were reported by 1612 (23%) of the participants during the 26-week follow-up. Alternating current and voltage below 1000 V were the most common forms of electricity. In most cases, the fingers/hands were the entry and exit points, but many were unable to specify the exit point. The participants categorised 73% of the electrical shocks as ‘not at all severe’, and most of the shocks did not cause any immediate physical damage. However, flashbacks were more common than physical consequences. Only a few of the participants contacted health services following an electrical shock, and even fewer were absent from work.

Conclusion

Nearly one-fourth of Danish electricians experienced one or more electrical shocks during a 26-week period, but most of the shocks are not perceived as severe, and have only limited immediate consequences.
Dietary fibre to reduce colon cancer risk in Alaska Native people: the Alaska FIRST randomised clinical trial protocol
Authors: Koller Kathryn R , Wilson Annette , Normolle Daniel P , Nicholson Jeremy K , Li Jia V , Kinross James , Lee Flora R , Flanagan Christie A , Merculieff Zoe T , Iyer Priya , Lammers Daniela L , Thomas Timothy K , O"Keefe Stephen J D
Published: August 2021

Introduction

Diet, shown to impact colorectal cancer (CRC) risk, is a modifiable environmental factor. Fibre foods fermented by gut microbiota produce metabolites that not only provide food for the colonic epithelium but also exert regulatory effects on colonic mucosal inflammation and proliferation. We describe methods used in a double-blinded, randomised, controlled trial with Alaska Native (AN) people to determine if dietary fibre supplementation can substantially reduce CRC risk among people with the highest reported CRC incidence worldwide.

Methods and analyses

Eligible patients undergoing routine screening colonoscopy consent to baseline assessments and specimen/data collection (blood, urine, stool, saliva, breath and colon mucosal biopsies) at the time of colonoscopy. Following an 8-week stabilisation period to re-establish normal gut microbiota post colonoscopy, study personnel randomise participants to either a high fibre supplement (resistant starch, n=30) or placebo (digestible starch, n=30) condition, repeating stool sample collection. During the 28-day supplement trial, each participant consumes their usual diet plus their supplement under direct observation. On day 29, participants undergo a flexible sigmoidoscopy to obtain mucosal biopsy samples to measure the effect of the supplement on inflammatory and proliferative biomarkers of cancer risk, with follow-up assessments and data/specimen collection similar to baseline. Secondary outcome measures include the impact of a high fibre supplement on the oral and colonic microbiome and biofluid metabolome.

Ethics and dissemination

Approvals were obtained from the Alaska Area and University of Pittsburgh Institutional Review Boards and Alaska Native Tribal Health Consortium and Southcentral Foundation research review bodies. A data safety monitoring board, material transfer agreements and weekly study team meetings provide regular oversight throughout the study. Study findings will first be shared with AN tribal leaders, health administrators, providers and community members. Peer-reviewed journal articles and conference presentations will be forthcoming once approved by tribal review bodies.

Trial registration number

NCT03028831.
What symptoms best predict severe distress in an online survey of UK health and social care staff facing COVID-19: development of the two-item Tipping Point Index
Authors: Brewin Chris R , Bloomfield Michael A P , Billings Jo , Harju-Seppänen Jasmine , Greene Talya
Published: August 2021

Objectives

COVID-19 has altered standard thresholds for identifying anxiety and depression. A brief questionnaire to determine when individuals are at a tipping point for severe anxiety or depression would greatly help decisions about when to seek assessment or treatment.

Design

Data were collected as part of the Frontline-COVID Study, a cross-sectional national online survey with good coverage of health and social care settings. New questionnaire items reflecting when coping was actually breaking down were compared with standard measures of severe anxiety and depression. Data were collected between 27 May and 23 July 2020.

Setting

The majority of participants worked in hospitals (53%), in nursing or care homes (15%), or in other community settings (30%).

Participants

Of 1194 qualifying respondents, 1038 completed the six tipping point items. Respondents included nurses, midwives, doctors, care workers, healthcare assistants, allied healthcare professionals and other non-medical staff. Over 90% were white and female.

Main outcome measures

Threshold for severe anxiety according to the Generalised Anxiety Disorder Scale-7 or moderately severe depression according to the Patient Health Questionnaire-9.

Results

Answering yes to one of two simple questions (‘Over the last week have you been often feeling panicky or on the point of losing control of your emotions?’, ‘Over the last week have you felt complete hopelessness about the future?’) demonstrated very high sensitivity (0.95, 95% CI 0.92 to 0.97) and negative predictive value (0.97, 95% CI 0.95 to 0.98). Answering yes to both questions yielded high specificity (0.90, 95% CI 0.87 to 0.92) and positive predictive value (0.72, 95% CI 0.67 to 0.77). Results were replicated in two random subsamples and were consistent across different genders, ethnic backgrounds, and health or social care settings.

Conclusions

Answering two simple yes/no questions can provide simple and immediate guidance to assist with decisions about whether to seek further assessment or treatment.
Process evaluation of co-designed interventions to improve communication of positive newborn bloodspot screening results
Authors: Chudleigh Jane , Holder Pru , Moody Louise , Simpson Alan , Southern Kevin , Morris Stephen , Fusco Francesco , Ulph Fiona , Bryon Mandy , Bonham James R , Olander Ellinor
Published: August 2021

Objective

To implement and evaluate co-designed interventions to improve communication of positive newborn bloodspot screening results and make recommendations for future research and practice.

Design

A process evaluation underpinned by Normalisation Process Theory.

Setting

Three National Health Service provider organisations in England.

Participants

Twenty-four healthcare professionals (7 newborn screening laboratory staff and 24 clinicians) and 18 parents were interviewed.

Interventions

Three co-designed interventions were implemented in practice: standardised laboratory proformas, communication checklists and an email/letter template.

Primary outcome measures

Acceptability and feasibility of the co-designed interventions.

Results

Auditing the implementation of these interventions revealed between 58%–76% of the items on the laboratory proforma and 43%–80% of items on the communication checklists were completed. Interviews with healthcare professionals who had used the interventions in practice provided positive feedback in relation to the purpose of the interventions and the ease of completion both of which were viewed as enhancing communication of positive newborn bloodspot screening results. Interviews with parents highlighted the perceived benefit of the co-designed interventions in terms of consistency, pacing and tailoring of information as well as providing reliable information to families following communication of the positive newborn bloodspot screening result. The process evaluation illuminated organisational and contextual barriers during implementation of the co-designed interventions in practice.

Conclusion

Variations in communication practices for positive newborn bloodspot screening results continue to exist. The co-designed interventions could help to standardise communication of positive newborn screening results from laboratories to clinicians and from clinicians to parents which in turn could improve parents’ experience of receiving a positive newborn bloodspot screening result. Implementation highlighted some organisational and contextual barriers to effective adoption of the co-designed interventions in practice.

Trial registration number

ISRCTN15330120.