bluuebunny/crossref_metadata_2025 huggingface dataset:
The prevalence and influencing factors of gag reflex in children aged 7–14 years in the dental setting
Authors: Gucyetmez Topal Burcu , Falay Civelek Sıdıka Beril , Tiras Melike , Yigit Tugba
Published: February 2023

Background

Gag reflex may occur in patients of all ages and often considered having a multifactorial aetiology.

Objective

The aim of the study was to evaluate the prevalence and influencing factors of gag reflex in Turkish children aged 7–14 years in the dental setting.

Methods

This cross‐sectional study was carried out among 320 children aged between 7 and 14 years. First, an anamnesis form which include sosyodemographic status, monthly level of income, children past medical and dental experiences was filled by mothers. Children's fear levels were evaluated using the Dental Subscale of Children's Fear Survey Schedule(CFSS‐DS) while mother's anxiety levels using the Modified Dental Anxiety Scale(MDAS). The revised dentist section of gagging problem assessment questionnaire (GPA‐R‐de) was used for both children and mothers. Statistical analysis was done with SPSS program.

Results

The prevalence of gag reflex among children was 34.1%, among mothers was 20.3%. The association between child and mother gagging was found statistically significant (χ2 = 53.121, p < 0.001). When the mother of the child gagged, the risk of child gagging increases 6.83 times (p < 0.001). Higher CFSS‐DS scores of children increase risk of gagging (OR = 1.052, p = 0.023). Children who were previously treated mostly in public hospitals significantly more likely to gag compared with private dental clinics (OR = 10.990, p < 0.001).

Conclusion

It was concluded that negative past dental experiences, previous dental treatments with local anaesthesia, history of hospital admission, number and place of previous dental visits, dental fear level of children, and low education level and gagging of mother have an influence on the gagging of children.
Bargain and Barter: China's Oil Trade with Iran
Authors: Azad Shirzad
Published: February 2023

The US withdrawal from the nuclear deal and its ratcheting up of sanctions aimed to cut Iran's oil revenues virtually to zero by reducing trade between Tehran and its top foreign customers, especially China. This article examines the dynamics of the Sino‐Iranian oil business and finds that the Chinese have never terminated their imports; instead, when Beijing cannot deal with Tehran directly, it continues the flow through subterranean methods. This practice holds some benefits for both sides, but the Iranian economy has become highly dependent on bartering with the East Asian power: exporting crude and receiving part of the revenues in Chinese goods and services. The two countries have vowed to keep up the oil trade, as sanctions have led Iran toward a growing economic and technological orientation toward the East.
What is “determinant” in the social determinants of health? A case seen through multiple lenses
Authors: Birnbaum Shira
Published: February 2023

Social determinants of health are a subject of growing interest, yet criticisms have emerged about the way determinants are conceptualized in nursing. A tendency to focus on readily observable living conditions and measurable demographic characteristics can divert attention, it has been said, from the less visible underlying processes which shape social life and health. To illustrate how the analytic perspective determines what becomes visible or invisible as a “determinant” in health, this paper presents a case exemplar. Drawing from news reports and research in real estate economics and urban policy analysis, it explores a single local infectious illness outbreak through a series of progressively more abstract units of inquiry, considering mechanisms of lending and debt financing, housing supply, property valuation, tax policy, change in the structure of the financial industry, and international patterns of migration and capital flow, among other factors, which contributed in various ways to creating unsafe living conditions. An analytic exercise calling attention to dynamism and complexity in social processes, the paper offers a political‐economy‐based approach that serves as a cautionary note against oversimplification in discussions of health causality.
Thismia guangdongensis (Thismiaceae), a new mycoheterotrophic species from China
Authors: Li Xiaojuan , Liu Ang , Zhang Dianxiang
Published: February 2023

Thismia guangdongensis, a fully mycoheterotrophic plant collected from Guangdong Province, China, is proposed and described as a new species. It is assigned to Thismia subsect. Brunonithismia based on having free tepals distinctly dissimilar in shape and size, and by phylogenetic evidence based on molecular data. This new species is morphologically similar to T. breviappendiculata from southern Myanmar, but easily distinguished from the latter by its orange campanulate hypanthium, inner surface of hypanthium with orange transverse bars, and filiform appendage of the inner whorl of tepals. With a plastome 20 379 bp in length and only 14 intact genes, the proposed new species has an extremely reduced plastome at the last stage of degradation, similar to most of the Thismia species previously studied.
Uncovering subtle mechanisms hindering the efficacy of biological control in plant invasions
Authors: Madeira Antunes Pedro
Published: February 2023

This article is a Commentary on Gao et al. (2023), 237: 2347–2359.
Defending Wittgenstein
Authors: Dehnel Piotr
Published: February 2023

Samuel J. Wheeler defends Wittgenstein's criticism of Cantor's set theory against the objections raised by Hilary Putnam. Putnam claims that Wittgenstein's dismissal of the basic tenets of this set theory concerning the noncountability of the set of real numbers was unfounded and ill‐conceived. In Wheeler's view, Putnam's charges result from his failure to grasp Wittgenstein's intention and, in particular, to consider the difference between empirical and logical impossibility. In my paper, I argue that Wheeler's defence is unsuccessful and, at the same time, that Putnam's objections go too far.
Sun Light Responsive 2D Covalent‐Organic Frameworks Platform as a Catalysts Boost C–H Bond Arylation and Dopamine Regeneration
Authors: Singh Rajnish K. , Yadav Rajesh K. , Pande Poran P. , Singh Satyam , Singh Pooja , Gupta Sarvesh K. , Gupta Shivani , Khare Prateek , Tripathi Santosh K. , Tiwary Dhanesh
Published: February 2023

Photocatalysis is one of the most promising methods for producing organic compounds with a renewable source of energy. Two‐dimensional covalent organic frameworks (2D COFs) are a type of polymer that has developed as a potential light‐harvesting catalyst for artificial photosynthesis with a design‐controllable platform that might be developed into a new type of cost‐effective and metal‐free photocatalyst. Here, we present a two‐dimensional covalent organic framework synthesis technique as a low‐cost and highly efficient visible light active flexible photocatalyst for C–H bond activation and dopamine regeneration. 2D COF were synthesized from tetramino‐benzoquinone (TABQ) and terapthaloyl chloride monomer through condensation polymerization reaction and the resultant photocatalyst have remarkable performance due to its visible light‐harvesting capacity, appropriate band gap, and highly organized π‐electron channels. The synthesized photocatalyst is capable to convert dopamine into leucodopaminechrome with a higher yield (77.08%) and also capable to activate the C–H bond between 4‐nitrobenzenediazonium tetrafluoroborate and pyrrole.
Phototropin phosphorylation of ROOT PHOTOTROPISM 2 and its role in mediating phototropism, leaf positioning, and chloroplast accumulation movement in Arabidopsis
Authors: Waksman Thomas , Suetsugu Noriyuki , Hermanowicz Pawel , Ronald James , Sullivan Stuart , Łabuz Justyna , Christie John M.
Published: February 2023

Directional movements impact the ability of plants to respond and adjust their growth accordingly to the prevailing light environment. The plasma‐membrane associated protein, ROOT PHOTOTROPISM 2 (RPT2) is a key signalling component involved in chloroplast accumulation movement, leaf positioning, and phototropism, all of which are regulated redundantly by the ultraviolet/blue light‐activated AGC kinases phototropin 1 and 2 (phot1 and phot2). We recently demonstrated that members of the NON‐PHOTOTROPIC HYPOCOTYL 3 (NPH3)/RPT2‐like (NRL) family in Arabidopsis thaliana, including RPT2, are directly phosphorylated by phot1. However, whether RPT2 is a substrate for phot2, and the biological significance of phot phosphorylation of RPT2 remains to be determined. Here, we show that RPT2 is phosphorylated by both phot1 and phot2 at a conserved serine residue (S591) within the C‐terminal region of the protein. Blue light triggered the association of 14‐3‐3 proteins with RPT2 consistent with S591 acting as a 14‐3‐3 binding site. Mutation of S591 had no effect on the plasma membrane localization of RPT2 but reduced its functionality for leaf positioning and phototropism. Moreover, our findings indicate that S591 phosphorylation within the C‐terminus of RPT2 is required for chloroplast accumulation movement to low level blue light. Taken together, these findings further highlight the importance of the C‐terminal region of NRL proteins and how its phosphorylation contributes to phot receptor signalling in plants.
N6‐Methyladenosine modification of mRNA contributes to the transition from 2D to 3D growth in the moss Physcomitrium patens
Authors: Garcias‐Morales David , Palomar V. Miguel , Charlot Florence , Nogué Fabien , Covarrubias Alejandra A. , Reyes José L.
Published: February 2023

Plants colonized the land approximately 470 million years ago, coinciding with the development of apical cells that divide in three planes. The molecular mechanisms that underly the development of the 3D growth pattern are poorly understood, mainly because 3D growth in seed plants starts during embryo development. In contrast, the transition from 2D to 3D growth in the moss Physcomitrium patens has been widely studied, and it involves a large turnover of the transcriptome to allow the establishment of stage‐specific transcripts that facilitate this developmental transition. N6‐Methyladenosine (m6A) is the most abundant, dynamic and conserved internal nucleotide modification present on eukaryotic mRNA and serves as a layer of post‐transcriptional regulation directly affecting several cellular processes and developmental pathways in many organisms. In Arabidopsis, m6A has been reported to be essential for organ growth and determination, embryo development and responses to environmental signals. In this study, we identified the main genes of the m6A methyltransferase complex (MTC), MTA, MTB and FIP37, in P. patens and demonstrate that their inactivation leads to the loss of m6A in mRNA, a delay in the formation of gametophore buds and defects in spore development. Genome‐wide analysis revealed several transcripts affected in the Ppmta background. We demonstrate that the PpAPB1–PpAPB4 transcripts, encoding central factors orchestrating the transition from 2D to 3D growth in P. patens, are modified by m6A, whereas in the Ppmta mutant the lack of the m6A marker is associated with a corresponding decrease in transcript accumulation. Overall, we suggest that m6A is essential to enable the proper accumulation of these and other bud‐specific transcripts directing the turnover of stage‐specific transcriptomes, and thus promoting the transition from protonema to gametophore buds in P. patens.
Low risk of human T‐lymphotropic virus infection in U.S. blood donors; Is it time to consider a one‐time selective testing approach?
Authors: Crowder Lauren A. , Haynes James M. , Notari Edward P. , Dodd Roger Y. , Stramer Susan L.
Published: February 2023

Background

U.S. blood donors are tested at each donation for human T‐lymphotropic virus (HTLV) antibodies. Depending on donor incidence and other mitigation/removal technologies, a strategy of one‐time selective donor testing should be considered.

Methods

Antibody seroprevalence was calculated for HTLV‐confirmed‐positive American Red Cross allogeneic blood donors from 2008 to 2021. Incidence was estimated for seven 2‐year time periods using confirmed‐positive repeat donors having seroconverted in 730 days. Leukoreduction failure rates were obtained from internal data from July 1, 2008–June 30, 2021. Residual risks were calculated using a 51‐day window period.

Results

Between 2008 and 2021, >75 million donations (>18 million donors) yielded 1550 HTLV seropositives. HTLV seroprevalence was 2.05 antibody‐positives per 100,000 donations (0.77 HTLV‐1, 1.03 HTLV‐2, 0.24 HTLV‐1/2), and 10.32 per 100,000 among >13.9 million first‐time donors. Seroprevalence differed significantly by virus type, sex, age, race/ethnicity, donor status, and U.S. census region. Over 14 years and 24.8 million person‐years of observation, 57 incident donors were identified (25 HTLV‐1, 23 HTLV‐2, and 9 HTLV‐1/2). Incidence decreased from 0.30 (13 cases) in 2008–2009 to 0.25 (7 cases) in 2020–2021. Female donors accounted for most incident cases (47 vs. 10 males). In the last 2‐year reporting period, the residual risk was 1 per 2.8 million donations and 1 per 3.3 billion donations when coupled with successful leukoreduction (0.085% failure rate).

Conclusions

HTLV donation seroprevalence for the years 2008–2021 varied by virus type and donor characteristics. Low HTLV residual risk and use of leukoreduction processes support the conclusion that a selective one‐time donor testing strategy should be considered.
IS THERE A DISTINCTIVE QUANTUM THEOLOGY?
Authors: Poon Wilson C. K. , McLeish Tom C. B.
Published: February 2023

Quantum mechanics (QM) is a favorite area of physics to feature in “science and religion” discussions. We argue that this is at least partly because the arcane results of QM can be deployed to make big theological claims by the linguistic sleight of hand of “register switching”—sliding imperceptibly from technical into everyday language using the same vocabulary. We clarify the discussion by deploying the formal mapping of QM into classical statistical mechanics (CSM) via the mathematical device of “Wick rotation.” This equivalence between QM and CSM suggests caution in claiming distinctiveness for quantum theologizing. After outlining two areas in which quantum insights nevertheless resonate with longstanding themes in theological reflection (hiddenness and visualizability), we suggest that both QM and CSM point to a theology of science in which scientists participate in the divine gaze on creation as imago Dei.
Viscous Theory for the Vibrations of Coaxial Cylinders: Analytical Formulas for the Fluid Forces and the Modal Added Coefficients
Authors: Lagrange Romain , Adela Puscas Maria
Published: February 2023

This article addresses the small-amplitude forced beam vibrations of two coaxial finite-length cylinders separated by a viscous Newtonian fluid. A new theoretical approach based on an Helmholtz expansion of the fluid velocity vector is carried out, leading to a full analytical expression of the fluid forces and subsequently of the modal added mass and damping coefficients. Our theory shows that the fluid forces are linear combinations of the Fourier harmonics of the vibration modes. The coefficients of the linear combinations are shown to depend on the aspect ratio of the cylinders, on the separation distance, and on the Stokes number. As a consequence, the linear fluid forces do not have, in general, the same shape as the forced vibration mode, so that the fluid makes it possible to couple vibration modes with different wave numbers. Compared to the previous works, the present theory includes the viscous effects of the fluid, accounts for the finite length of the cylinders, does not rely on the assumption of a narrow annulus, and covers in a unique formulation all types of classical boundary conditions for an Euler–Bernoulli beam. The theoretical predictions for the modal added mass and damping coefficients (self and cross) are corroborated numerically, considering rigid, pinned-pinned, and clamped-free vibrations.
Axisymmetric Indentations of an Elastic Half-Space With Tensed Surface/Membrane in the Johnson–Kendall–Roberts Adhesive Approximation
Authors: Yuan Weike , Niu Xinrui , Wang Gangfeng
Published: February 2023

Owing to the significant effects of adhesive force and surface/membrane tension, the classical contact models often fail to describe the indentation responses of soft materials and biological systems. This work addresses the axisymmetric indentation of an elastic substrate with constant surface/membrane tension by a spherical, conical, or cylindrical flat indenter in the Johnson–Kendall–Roberts adhesive approximation. On the basis of non-adhesive contact solutions accounting for the surface/membrane tension effect, explicit expressions for the external load and depth with respect to the contact radius are derived for the adhesive contact cases, which act as the theoretical fundamental for the accurate analysis of indentation tests. Despite using different correction functions, the results for spherical indentation are consistent with the solution of previous studies. It is found that the role of surface/membrane tension in the adhesive contact behavior is controlled by a dimensionless parameter. As the parameter gets larger, the pull-off force and the contact size at zero-external load for spherical and conical indentations are smaller, whereas the pull-off force for cylindrical flat indentation is higher.
A Constitutive Model of Water-Triggered Shape Memory Hydrogels and Its Finite Element Implementation
Authors: Xue Yiheng , Zhou Zidi , Lei Jincheng , Liu Zishun
Published: February 2023

Shape memory hydrogel is a type of hydrogel whose shape can transform between a temporary shape and its initial shape when exposed to external stimuli, such as water, temperature, and pH. Over the last decade, shape memory hydrogels have gained increasing interest owing to their distinct properties; however, constitutive models to describe their shape memory mechanism are still lacking. In this paper, we propose a constitutive model for water-triggered shape memory hydrogels based on the transition between the sparse and dense phases. In the model, the shape memory process is identified using two internal variables: the frozen deformation gradient and dense phase volume fraction. To validate the model for describing shape memory effects, we implemented the model in the finite element method using a user-defined element (UEL) subroutine in ABAQUS. To verify the accuracy of the proposed UEL, we simulated the water-triggered shape memory effects in different recovery processes under different uniaxial loads. Furthermore, we investigated the water-triggered shape memory behavior of a self-bending bilayer structure and a four-arm gripper structure using both experiments and simulations. Good agreement was observed between the simulation and experimental results.
Hyperbolicity, Mach Lines, and Super-Shear Mode III Steady-State Fracture in Magneto-Flexoelectric Materials, Part I: Methodology
Authors: Giannakopoulos A. E. , Knisovitis C. , Charalambopoulos A. , Zisis Th. , Rosakis Ares J.
Published: February 2023

This work examines the sub-shear and super-shear steady-state growth of mode III fractures in flexoelectric materials, nonetheless, exhibiting Mach type shock wave patterns that resemble reported lattice dynamics results and three-dimensional calculations and experiments. Our mathematical models provide weak discontinuous solutions of the steady-state dynamic equations. In flexoelectric solids, super-shear rupture is possible with Mach lines appearing at sub-shear as well as super-shear crack rupture velocities. This is contrary to classical singular elastodynamics, where the notions of super-shear growth and hyperbolicity coincide. The results show that the deformation near the crack-tip agrees with studies based on lattice dynamics. In the first part of this work, a novel finite element approach has been developed where the problem is decomposed into two prestressed plates that are interconnected, resulting into the predicted radiation patterns and Mach lines. The polarization field is obtained from the calculated displacement field and is used in turn to calculate the magnetic and the electric fields. The analysis offers an analogy to the co-seismic magnetic fields encountered during mode III dominated earthquake rupture events.
Feasibility Study of Upper Limb Control Method Based on Electromyography-Angle Relation
Authors: Lento Bianca , Aoustin Yannick , Zielinska Teresa
Published: February 2023

The paper describes the method of predicting the angular position of the human upper limb using EMG signals. A neural network with fuzzy logic was used for this purpose. The main goal of the work, namely, to demonstrate that a neural network with fuzzy logic is a useful tool for predicting motion based on EMG signals, has been completed. Two EMG signals from those muscles of the human arm that show the greatest activity during the load lifting are used. When determining the driving torques, the differences between the intended and the actual angular position are taken into account, and a simplified dynamics model was used for the calculations. In order to validate the method, the actual and predicted angles are compared and the differences between the moments determined on the basis of anticipated angular positions and the moments provided by the opensim simulator using real angular positions are examined.
Comparative Analysis of Infrared Signatures of Turbofan Engine Exhaust System With or Without Afterburning
Authors: Shi Xiaojuan , Wei Xin , Ji Honghu
Published: February 2023

The flow fields and infrared signatures of a turbofan engine axisymmetric exhaust system with or without afterburning have been numerically investigated. The flow fields of the exhaust system have been calculated using a commercial numerical simulation software, whereas the infrared signatures have been calculated by the software nuaa-ir (numerical analysis of aircraft's infrared signature) developed by the current authors' research team. The spectral and integral radiation intensity in the waveband of 3–5 μm of the axisymmetric exhaust system have been calculated and analyzed. The results show that the thrust of the axisymmetric exhaust system with afterburning is increased by 55% as compared with nonafterburning. The main infrared radiation source of the exhaust system with afterburning is the plume. The infrared radiation of the plume accounts for 65% of the total infrared radiation of the exhaust system in the downstream axial direction. The maximum integral radiation intensity of the exhaust system with afterburning is nearly seventeen times that of without afterburning. The integral radiation intensity of the exhaust system in the downstream axial direction with afterburning is about four times that of without afterburning. The integral radiation intensity of the exhaust system in the lateral direction is about 54 times higher than that without afterburning.
Implementation of Bartlett matched-field processing using interpretable complex convolutional neural network
Authors: Liu Mingda , Niu Haiqiang , Li Zhenglin
Published: February 2023

Neural networks have been applied to underwater source localization and achieved better performance than the conventional matched-field processing (MFP). However, compared with MFP, the neural networks lack physical interpretability. In this work, an interpretable complex convolutional neural network based on Bartlett processor (BC-CNN) for underwater source localization is designed, the output and structure of which have clear physical meanings. The relationship between the convolution weights of BC-CNN and replica pressure of MFP is discussed, which effectively presents the interpretability of the BC-CNN. Simulation experiments using two kinds of labels demonstrate the equivalence between the Bartlett MFP and BC-CNN.
Comment on “Sexual selection promotes giraffoid head-neck evolution and ecological adaptation”
Authors: Hou Sukuan , Shi Qinqin , Benton Michael J. , Solounias Nikos
Published: February 2023

Wang
et al
. (Research Articles, 3 June 2022, eabl8316) reported an early Miocene giraffoid that exhibited fierce head-butting behavior and concluded that sexual selection promoted head-neck evolution in giraffoids. However, we argue that this ruminant is not a giraffoid and thus that the hypothesis that sexual selection promoted giraffoid head-neck evolution is not sufficiently supported.
A volatile sex attractant of tsetse flies
Authors: Ebrahim Shimaa A. M. , Dweck Hany K. M. , Weiss Brian L. , Carlson John R.
Published: February 2023

Tsetse flies transmit trypanosomes—parasites that cause devastating diseases in humans and livestock—across much of sub-Saharan Africa. Chemical communication through volatile pheromones is common among insects; however, it remains unknown if and how such chemical communication occurs in tsetse flies. We identified methyl palmitoleate (MPO), methyl oleate, and methyl palmitate as compounds that are produced by the tsetse fly
Glossina morsitans
and elicit strong behavioral responses. MPO evoked a behavioral response in male—but not virgin female—
G. morsitans
.
G. morsitans
males mounted females of another species,
Glossina fuscipes
, when they were treated with MPO. We further identified a subpopulation of olfactory neurons in
G. morsitans
that increase their firing rate in response to MPO and showed that infecting flies with African trypanosomes alters the flies’ chemical profile and mating behavior. The identification of volatile attractants in tsetse flies may be useful for reducing disease spread.
Response to comment on “Sexual selection promotes giraffoid head-neck evolution and ecological adaptation”
Authors: Wang Shi-Qi , Meng Jin , Mennecart Bastien , Costeur Loïc , Ye Jie , Li Chunxiao , Zhang Chi , Zhang Ji , Aiglstorfer Manuela , Wang Yang , Wu Yan , Wu Wen-Yu , Deng Tao
Published: February 2023

Hou
et al
. challenged the giraffoid affinity of
Discokeryx
and its ecology and behavior. In our response we reiterate that
Discokeryx
is a giraffoid that, along with
Giraffa
, shows extreme evolution of head-neck morphologies that were presumably shaped by selective pressure from sexual competition and marginal environments.
Photonic tinkering in the open ocean
Authors: Feller Kate , Porter Megan
Published: February 2023

Light-manipulating materials are discovered in the eyeglitter of pelagic crustaceans
Possible psychedelic therapeutic mechanism
Authors: Hess Evan M. , Gould Todd D.
Published: February 2023

Psychedelics act on intracellular serotonin receptors that are not accessible by serotonin alone
Science and its stakeholders
We the Scientists: How a Daring Team of Parents and Doctors Forged a New Path for Medicine
Amy Dockser Marcus
Riverhead Books, 2023. 256 pp.
Authors: Guerrini Christi J.
Published: February 2023

Patients’ families became research partners in a quest to understand a rare genetic disease
Decoding foreign antigen tolerance
Authors: Vento-Tormo Roser
Published: February 2023

Cell atlases of human tolerogenic milieus guide transformative immunotherapies
Japan moves to bolster its vaccine R&D sector
Authors: Normile Dennis
Published: February 2023

Major funding effort aims to address weaknesses exposed by COVID-19 pandemic
United States tiptoes into solar geoengineering research
Authors: Voosen Paul
Published: February 2023

Campaign seeks to understand reflective particles in the stratosphere, which planet-cooling schemes would enhance
U.S. measurement institute’s labs said to need major upgrade
Authors: Service Robert F.
Published: February 2023

National academies report finds that disrepair at NIST facilities threatens U.S. economic growth
Magmatic records of subduction and closure of the Meso-Tethys Ocean in the northern-central Tibetan Plateau
Authors: Wang Wei , Zhai Qing-guo , Hu Pei-yuan , Tang Yue , Wang Hai-tao , Zhu Zhi-cai
Published: February 2023

The evolution of the Tethys Ocean has received much research attention; however, the timing and subduction mechanisms involved in the closure of the Bangong-Nujiang Meso-Tethys Ocean remain poorly constrained. In this study, we present geological, geochronological, geochemical, and zircon isotopic data from Cretaceous magmatic rocks and combine these with previously published data within the central Bangong-Nujiang suture zone in the north-central Tibetan Plateau. The integrated data update the regional tectonic framework and enable a comprehensive geodynamic model to be developed for the subduction and ocean closure events. In detail, temporal and spatial variations in the Jurassic−Cretaceous magmatism reflect the influence of the northward subduction of the Dongqiao-Amdo oceanic basin and the bidirectional subduction of the Bangong-Nujiang Meso-Tethys oceanic crust. The evolution of the Bangong-Nujiang Meso-Tethys Ocean further involved initial intra-ocean subduction, slab rollback, and flat subduction, as evidenced by two phases of north-south migration of magmatism at ca. 190−160 and 160−130 Ma and a magmatic hiatus at 160−140 Ma. The ocean closed during a two-stage process, including the closure of the Dongqiao-Amdo oceanic basin to the north and the Bangong-Nujiang Meso-Tethys Ocean to the south. The Dongqiao-Amdo oceanic basin closed soon after ca. 180 Ma, accompanied by continent-continent collision between the Amdo microcontinent and the South Qiangtang terrane. The Bangong-Nujiang Meso-Tethys Ocean closed at 130−120 Ma, corresponding to a period of waning magmatism. This closure represented complete oceanic closure and caused an arc-continent collisional event involving the Baingoin magmatic arc, the Amdo microcontinent, and the Lhasa terrane. The Lower Cretaceous terrestrial strata and their basal unconformity mark the final closure of the ocean, and the Early Cretaceous ocean islands might have formed before ca. 130 Ma.
Risk of amputation with canagliflozin across categories of age and cardiovascular risk in three US nationwide databases: cohort study
Authors: Fralick Michael , Kim Seoyoung C , Schneeweiss Sebastian , Everett Brendan M , Glynn Robert J , Patorno Elisabetta
Published: February 2023

Objective

To estimate the rate of lower limb amputation among adults newly prescribed canagliflozin according to age and cardiovascular disease.

Design

Population based, new user, cohort study.

Data sources

Two commercial and Medicare claims databases, 2013-17.

Participants

Patients newly prescribed canagliflozin were propensity score matched 1:1 with patients newly prescribed a glucagon-like peptide-1 (GLP-1) receptor agonist. Hazard ratios and rate differences per 1000 person years were computed for the rate of lower limb amputation in the following four groups: group 1, patients aged less than 65 years without baseline cardiovascular disease; group 2, patients aged less than 65 with baseline cardiovascular disease; group 3, patients aged 65 or older without baseline cardiovascular disease; group 4, patients aged 65 or older with baseline cardiovascular disease. Within each group, pooled hazard ratio and rate difference per 1000 person years were calculated by meta-analysis.

Intervention

Canagliflozin versus a GLP-1 agonist.

Main outcome measures

Lower limb amputation requiring surgery.

Results

Across the three databases, 310 840 propensity score matched adults who started canagliflozin or a GLP-1 agonist were identified. The hazard ratio and rate difference per 1000 person years for amputation in adults receiving canagliflozin compared with a GLP-1 agonist for each group was: group 1, hazard ratio 1.09 (95% confidence interval 0.83 to 1.43), rate difference 0.12 (−0.31 to 0.55); group 2, hazard ratio 1.18 (0.86 to 1.62), rate difference 1.06 (−1.77 to 3.89); group 3, hazard ratio 1.30 (0.52 to 3.26), rate difference 0.47 (−0.73 to 1.67); and group 4, hazard ratio 1.73 (1.30 to 2.29), rate difference 3.66 (1.74 to 5.59).

Conclusions

The increase in rate of amputation with canagliflozin was small and most apparent on an absolute scale for adults aged 65 or older with baseline cardiovascular disease, resulting in a number needed to treat for an additional harmful outcome of 556 patients at six months (that is, 18 more amputations per 10 000 people who received canagliflozin). These results help to contextualize the risk of amputation with canagliflozin in routine care.
Prevalence of diabetes and pre-diabetes in Sri Lanka: a new global hotspot–estimates from the Sri Lanka Health and Ageing Survey 2018/2019
Authors: Rannan-Eliya Ravindra Prasan , Wijemunige Nilmini , Perera Prasadini , Kapuge Yasodhara , Gunawardana Nishani , Sigera Chathurani , Jayatissa Renuka , Herath H M M , Gamage Anuji , Weerawardena Nethmi , Sivagnanam Ishwari , Dalpatadu Shanti , Samarage Sarath , Samarakoon Upeka , Samaranayake Navami , Pullenayegam Cheroni , Perera Bilesha
Published: February 2023

Introduction

This study’s objective was to produce robust, comparable estimates of the prevalence of diabetes and pre-diabetes in the Sri Lankan adult population, where previous studies suggest the highest prevalence in South Asia.

Research design and methods

We used data on 6661 adults from the nationally representative 2018/2019 first wave of the Sri Lanka Health and Ageing Study (SLHAS). We classified glycemic status based on previous diabetes diagnosis, and either fasting plasma glucose (FPG), or FPG and 2-hour plasma glucose (2-h PG). We estimated crude and age-standardized prevalence of pre-diabetes and diabetes and by major individual characteristics weighting the data to account for study design and subject participation.

Results

Crude prevalence of diabetes in adults was 23.0% (95% CI 21.2% to 24.7%) using both 2-h PG and FPG, and age-standardized prevalence was 21.8% (95% CI 20.1% to 23.5%). Using only FPG, prevalence was 18.5% (95% CI 7.1% to 19.8%). Previously diagnosed prevalence was 14.3% (95% CI 13.1% to 15.5%) of all adults. The prevalence of pre-diabetes was 30.5% (95% CI 28.2% to 32.7%). Diabetes prevalence increased with age until ages ≥70 years and was more prevalent in female, urban, more affluent, and Muslim adults. Diabetes and pre-diabetes prevalence increased with body mass index (BMI) but was as high as 21% and 29%, respectively, in those of normal weight.

Conclusions

Study limitations included using only a single visit to assess diabetes, relying on self-reported fasting times, and unavailability of glycated hemoglobin for most participants. Our results indicate that Sri Lanka has a very high diabetes prevalence, significantly higher than previous estimates of 8%–15% and higher than current global estimates for any other Asian country. Our results have implications for other populations of South Asian origin, and the high prevalence of diabetes and dysglycemia at normal body weight indicates the need for further research to understand the underlying drivers.
Pilot trial comparing COVID-19 publication database to conventional online search methods
Authors: Torfs-Leibman Camille , Ashikaga Takamaru , Krag David , Lunna Shania , Robtoy Sarah , Bombardier Rachel
Published: February 2023

Background and objectives

Literature review using search engines results in a list of manuscripts but does not provide the content contained in the manuscripts. Our goal was to evaluate user performance-based criteria of concept retrieval accuracy and efficiency using a new database system that contained information extracted from 1000 COVID-19 articles.

Methods

A sample of 17 students from the University of Vermont were randomly assigned to use the COVID-19 publication database or their usual preferred search methods to research eight prompts about COVID-19. The relevance and accuracy of the evidence found for each prompt were graded. A Cox proportional hazards’ model with a sandwich estimator and Kaplan-Meier plots were used to analyse these data in a time-to-correct answer context.

Results

Our findings indicate that students using the new information management system answered significantly more prompts correctly and, in less time, than students using conventional research methods. Bivariate models for demographic factors indicated that previous research experience conferred an advantage in study performance, though it was found to be independent from the assigned research method.

Conclusions

The results from this pilot randomised trial present a potential tool for more quickly and thoroughly navigating the literature on expansive topics such as COVID-19.
Data consistency in the English Hospital Episodes Statistics database
Authors: Hardy Flavien , Heyl Johannes , Tucker Katie , Hopper Adrian , Marchã Maria J , Briggs Tim W R , Yates Jeremy , Day Jamie , Wheeler Andrew , Eve-Jones Sue , Gray William K
Published: February 2023

Background

To gain maximum insight from large administrative healthcare datasets it is important to understand their data quality. Although a gold standard against which to assess criterion validity rarely exists for such datasets, internal consistency can be evaluated. We aimed to identify inconsistencies in the recording of mandatory International Statistical Classification of Diseases and Related Health Problems, tenth revision (ICD-10) codes within the Hospital Episodes Statistics dataset in England.

Methods

Three exemplar medical conditions where recording is mandatory once diagnosed were chosen: autism, type II diabetes mellitus and Parkinson’s disease dementia. We identified the first occurrence of the condition ICD-10 code for a patient during the period April 2013 to March 2021 and in subsequent hospital spells. We designed and trained random forest classifiers to identify variables strongly associated with recording inconsistencies.

Results

For autism, diabetes and Parkinson’s disease dementia respectively, 43.7%, 8.6% and 31.2% of subsequent spells had inconsistencies. Coding inconsistencies were highly correlated with non-coding of an underlying condition, a change in hospital trust and greater time between the spell with the first coded diagnosis and the subsequent spell. For patients with diabetes or Parkinson’s disease dementia, the code recording for spells without an overnight stay were found to have a higher rate of inconsistencies.

Conclusions

Data inconsistencies are relatively common for the three conditions considered. Where these mandatory diagnoses are not recorded in administrative datasets, and where clinical decisions are made based on such data, there is potential for this to impact patient care.
Extension of the Unified Theory of Acceptance and Use of Technology 2 model for predicting mHealth acceptance using diabetes as an example: a cross-sectional validation study
Authors: Schretzlmaier Patrik , Hecker Achim , Ammenwerth Elske
Published: February 2023

Objectives

Mobile health applications are instrumental in the self-management of chronic diseases like diabetes. Technology acceptance models such as Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) have proven essential for predicting the acceptance of information technology. However, earlier research has found that the constructs “perceived disease threat” and “trust” should be added to UTAUT2 in the mHealth acceptance context. This study aims to evaluate the extended UTAUT2 model for predicting mHealth acceptance, represented by behavioral intention, using mobile diabetes applications as an example.

Methods

We extended UTAUT2 with the additional constructs “perceived disease threat” and “trust”. We conducted a web-based survey in German-speaking countries focusing on patients with diabetes and their relatives who have been using mobile diabetes applications for at least 3 months. We analysed 413 completed questionnaires by structural equation modelling.

Results

We could confirm that the newly added constructs “perceived disease threat” and “trust” indeed predict behavioural intention to use mobile diabetes applications. We could also confirm the UTAUT2 constructs “performance expectancy” and “habit” to predict behavioural intention to use mobile diabetes applications. The results show that the extended UTAUT2 model could explain 35.0% of the variance in behavioural intention.

Discussion

Even if UTAUT2 is well established in the information technologies sector to predict technology acceptance, our results reveal that the original UTAUT2 should be extended by “perceived disease threat” and “trust” to better predict mHealth acceptance.

Conclusion

Despite the newly added constructs, UTAUT2 can only partially predict mHealth acceptance. Future research should investigate additional mHealth acceptance factors, including how patients perceive trust in mHealth applications.
Predicting emerging SARS-CoV-2 variants of concern through a One Class dynamic anomaly detection algorithm
Authors: Nicora Giovanna , Salemi Marco , Marini Simone , Bellazzi Riccardo
Published: February 2023

Objectives

The objective of this study is the implementation of an automatic procedure to weekly detect new SARS-CoV-2 variants and non-neutral variants (variants of concern (VOC) and variants of interest (VOI)).

Methods

We downloaded spike protein primary sequences from the public resource GISAID and we represented each sequence as k-mer counts. For each week since 1 July 2020, we evaluate if each sequence represents an anomaly based on a One Class support vector machine (SVM) classification algorithm trained on neutral protein sequences collected from February to June 2020.

Results

We assess the ability of the One Class classifier to detect known VOC and VOI, such as Alpha, Delta or Omicron, ahead of their official classification by health authorities. In median, the classifier predicts a non-neutral variant as outlier 10 weeks before the official date of designation as VOC/VOI.

Discussion

The identification of non-neutral variants during a pandemic usually relies on indicators available during time, such as changing population size of a variant. Automatic variant surveillance systems based on protein sequences can enhance the fast identification of variants of potential concern.

Conclusion

Machine learning, and in particular One Class SVM classification, can support the detection of potentially VOC/VOI variants during an evolving pandemics.
Usability, acceptability and feasibility of a novel technology with visual guidance with video and audio recording during newborn resuscitation: a pilot study
Authors: KC Ashish , Kong So Yeon Joyce , Basnet Omkar , Haaland Solveig Haukås , Bhattarai Pratiksha , Gomo Øystein , Gurung Rejina , Ahlsson Fredrik , Meinich-Bache Øyvind , Axelin Anna , Malla Honey , Basula Yuba Nidhi , Pathak Om Krishna , Pokharel Sunil Mani , Subedi Hira , Myklebust Helge
Published: February 2023

Objective

Inadequate adherence to resuscitation for non-crying infants will have poor outcome and thus rationalise a need for real-time guidance and quality improvement technology. This study assessed the usability, feasibility and acceptability of a novel technology of real-time visual guidance, with sound and video recording during resuscitation.

Setting

A public hospital in Nepal.

Design

A cross-sectional design.

Intervention

The technology has an infant warmer with light, equipped with a tablet monitor, NeoBeat and upright bag and mask. The tablet records resuscitation activities, ventilation sound, heart rate and display time since birth. Healthcare providers (HCPs) were trained on the technology before piloting.

Data collection and analysis

HCPs who had at least 8 weeks of experience using the technology completed a questionnaire on usability, feasibility and acceptability (ranged 1–5 scale). Overall usability score was calculated (ranged 1–100 scale).

Results

Among the 30 HCPs, 25 consented to the study. The usability score was good with the mean score (SD) of 68.4% (10.4). In terms of feasibility, the participants perceived that they did not receive adequate support from the hospital administration for use of the technology, mean score (SD) of 2.44 (1.56). In terms of acceptability, the information provided in the monitor, that is, time elapsed from birth was easy to understand with mean score (SD) of 4.60 (0.76).

Conclusion

The study demonstrates reasonable usability, feasibility and acceptability of a technological solution that records audio visual events during resuscitation and provides visual guidance to improve care.
Understanding barriers of receiving short message service appointment reminders across African regions: a systematic review
Authors: Demsash Addisalem Workie , Tegegne Masresha Derese , Walle Agmasie Damtew , Wubante Sisay Maru
Published: February 2023

Objective

Patients frequently miss their medical appointments. Therefore, short message service (SMS) has been used as a strategy for medical and healthcare service appointment reminders. This systematic review aimed to identify barriers to SMS appointment reminders across African regions.

Methods

PubMed, Google Scholar, Semantic Scholar and Web of Science were used for searching, and hand searching was done. Original studies written in English, conducted in Africa, and published since 1 December 2018, were included. The standard quality assessment checklist was used for the quality appraisal of the included studies. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart diagram was used for study selection and screening, and any disagreements were resolved via discussions.

Results

A total of 955 articles were searched, 521 studies were removed due to duplication and 105 studies were assessed for eligibility. Consequently, nine studies met the inclusion criteria. Five out of nine included studies were done by randomised control trials. The barriers that hampered patients, mothers and other parental figures of children when they were notified via SMS of medical and health services were identified. Among the 11 identified barriers, illiteracy, issues of confidentiality, familiarised text messages, inadequate information communication technology infrastructure, being a rural resident and loss of mobile phones occurred in at least two studies.

Conclusions

SMS is an effective and widely accepted appointment reminder tool. However, it is hampered by numerous barriers. Hence, we gathered summarised information about users’ barriers to SMS-based appointment reminders. Therefore, stakeholders should address existing identified barriers for better Mhealth interventions.

PROSPERO registration number

CRD42022296559.