bluuebunny/crossref_metadata_2025 huggingface dataset:
Does abnormal Doppler on cranial ultrasound predict disability in infants with hypoxic‐ischaemic encephalopathy? A systematic review
Authors: Rath Chandra , Rao Shripada , Suryawanshi Pradeep , Desai Saumil , Chetan Chinmay , Patil Karamchand , Patole Sanjay
Published: April 2022

Aim

To evaluate whether abnormal resistive index or cerebral blood flow velocity (CBFV) on cranial ultrasound predicts disability (≥1 year) in infants with hypoxic‐ischaemic encephalopathy (HIE).

Method

This was a systematic review and meta‐analysis of studies comparing developmental outcomes of infants with HIE with normal versus abnormal resistive index or CBFV.

Results

Twenty‐six studies were included (pre‐therapeutic hypothermia era, 20; therapeutic hypothermia era, six). Data from 15 studies (pre‐therapeutic hypothermia, 10; therapeutic hypothermia, five) were available for meta‐analysis. Pooled sensitivity and specificity, summary area under the receiver operating characteristic curve, and diagnostic odds ratio of resistive index or CBFV for predicting ‘death or severe disability’ were as follows. Pre‐therapeutic hypothermia era: 0.83 (95% confidence interval [CI] 0.45–0.97) and 0.92 (95% CI 0.74–0.98), 0.94 (95% CI 0.92–0.96), 54 (95% CI 7–391). Therapeutic hypothermia era (measurements before therapeutic hypothermia): 0.62 (95% CI 0.41–0.80) and 0.96 (95% CI 0.88–0.99), 0.93 (95% CI 0.89–0.94), 23 (95% CI 6–91). Therapeutic hypothermia era (measurements during/after therapeutic hypothermia): 0.51 (95% CI 0.24–0.78) and 0.83 (95% CI 0.73–0.90), 0.81 (95% CI 0.78–0.85), 5 (95% CI 2–13). Overall Grading of Recommendations Assessment, Development and Evaluation (GRADE) rating of evidence was ‘low’ or ‘very low’.

Interpretation

Low‐level evidence suggests that abnormal resistive index or CBFV can predict death or disability with high sensitivity and specificity in infants with HIE who are not cooled. The specificity of these tests was high when performed before starting cooling in infants who received therapeutic hypothermia.

What this paper adds

Cerebral doppler ultrasound may be useful in predicting death or disability in infants with hypoxic‐ischaemic encephalopathy who are not cooled.

Cerebral doppler ultrasound may also be useful in infants who are cooled, if done before starting cooling.

Cerebral doppler ultrasound may not be useful when performed during or after completing cooling.
Whose voice counts? Examining government‐donor negotiations in the design of Ethiopia’s large‐scale education reforms for equitable learning
Authors: Carvalho Shelby , Asgedom Amare , Rose Pauline
Published: April 2022

Motivation

The Government of Ethiopia has a long‐standing commitment to improving the quality of education. In recent years, this has shifted to include a more explicit focus on equity in learning outcomes. In this paper, we examine the education reform design process in the context of Ethiopia’s political environment which is widely recognised as a strong developmental state.

Purpose

The article examines how federal, regional, and international donor actors negotiate their interests in relation to Ethiopia’s national quality education reform programme, the General Education Quality Improvement Programme for Equity (GEQIP‐E).

Methods and approach

We conducted 81 semi‐structured, key informant interviews with federal and regional government officials and international donors who were involved in the design of GEQIP‐E.

Findings

We find that federal government was able to leverage considerable political influence over high‐level priorities and the framing of GEQIP‐E. Large donors leveraged financial influence to exclude some specific priorities, while smaller donors were able to draw on social influence and technical expertise to include priorities aligned with their interests. Regional governments—which are responsible for policy implementation—were largely excluded from the reform design process.

Policy implications

Our analysis highlights the importance of recognizing and understanding different forms of influence in the dynamic process of negotiating reform between government and donors. It identifies that both government and donor voices counted in the process of negotiations, but in different ways and to varying degrees. Understanding how different actors draw on their relative political, financial, and social influence is vital for ensuring successful implementation and sustainability. Importantly, we identify that voices of local actors are left out.
Effect of eculizumab treatment in patients with paroxysmal nocturnal hemoglobinuria with or without high disease activity: Real‐world findings from the International Paroxysmal Nocturnal Hemoglobinuria Registry
Authors: Höchsmann Britta , de Fontbrune Flore Sicre , Lee Jong Wook , Kulagin Alexander D. , Hillmen Peter , Wilson Amanda , Marantz Jing L. , Schrezenmeier Hubert
Published: April 2022

Background

The effects of eculizumab treatment in paroxysmal nocturnal hemoglobinuria (PNH) patients with or without high‐disease activity (HDA), defined by LDH ≥ 1.5 × ULN and history of major adverse vascular events (MAVEs; including thrombotic events [TEs]); anemia; and/or physician‐reported abdominal pain, dyspnea, dysphagia, erectile dysfunction, fatigue, and/or hemoglobinuria, in the International PNH Registry were evaluated.

Methods

Registry patients were stratified by baseline HDA and eculizumab‐treatment status. Longitudinal changes in laboratory and clinical PNH‐related endpoints were evaluated using linear mixed models (continuous variables) or Poisson regression (incidence rates).

Results

As of May 1, 2017, 3009 patients (HDA/eculizumab‐treated, n = 913; HDA/never‐treated, n = 651; no‐HDA/eculizumab‐treated, n = 173; no‐HDA/never‐treated, n = 1272) were analyzed. Higher proportions of eculizumab‐treated patients had HDA and history of MAVEs. In patients with and without HDA, respectively, eculizumab treatment resulted in reductions from baseline for (1) LDH ratio (mean [SD]: −5.3 [4.0] and −2.3 [3.8]); (2) incidence rate ratio (IRR) for MAVEs (−80% and −70%); (3) IRR for TEs (−80% for both); and (4) units of red blood cell transfusions per year (from 6.8 to 2.8 and 3.6 to 2.5 units).

Conclusions

Eculizumab treatment in a real‐world setting improved outcomes, including substantial decreases in hemolysis, MAVE rates, TEs, and transfusions in PNH patients regardless of HDA.
The correlation between dynamic functional architecture and response to electroconvulsive therapy combined with antipsychotics in schizophrenia
Authors: Gong Jie , Cui Long‐Biao , Zhao Ying‐Song , Liu Zhao‐Wen , Yang Xue‐Juan , Xi Yi‐Bin , Liu Lin , Liu Peng , Sun Jin‐Bo , Zhao Shu‐Wan , Liu Xiao‐Fan , Jia Jie , Li Ping , Yin Hong , Qin Wei
Published: April 2022

Attempts to determine why some patients respond to electroconvulsive therapy (ECT) are valuable in schizophrenia. Schizophrenia is associated with aberrant dynamic functional architecture, which might impact the efficacy of ECT. We aimed to explore the relationship between pre‐treatment temporal variability and ECT acute efficacy. Forty‐eight patients with schizophrenia and 30 healthy controls underwent functional magnetic resonance imaging to examine whether patterns of temporary variability of functional architecture differ between high responders (HR) and low responders (LR) at baseline. Compared with LR, HR exhibited significantly abnormal temporal variability in right inferior front gyrus (IFGtriang.R), left temporal pole (TPOsup.L) and right middle temporal gyrus (MTG.R). In the pooled patient group, ∆PANSS was correlated with the temporal variability of these regions. Patients with schizophrenia with a distinct dynamic functional architecture appear to reveal differential response to ECT. Our findings provide not only an understanding of the neural functional architecture patterns that are found in schizophrenia but also the possibility of using these measures as moderators for ECT selection.
Safety and tolerability of SARS‐Cov‐2 vaccination in patients with myasthenia gravis: A multicenter experience
Authors: Farina Antonio , Falso Silvia , Cornacchini Sara , Spagni Gregorio , Monte Gabriele , Mariottini Alice , Massacesi Luca , Barilaro Alessandro , Evoli Amelia , Damato Valentina
Published: April 2022

Background and purpose

During the COVID‐19 pandemic, myasthenia gravis (MG) patients have been identified as subjects at high risk of developing severe COVID‐19, and thus were offered vaccination with priority. The lack of direct data on the safety and tolerability of SARS‐CoV‐2 vaccines in MG have contributed to vaccine hesitancy. To address this issue, the safety and tolerability of SARS‐CoV‐2 vaccines were assessed in a large cohort of MG patients from two referral centers.

Methods

Patients with confirmed MG diagnosis, consecutively seen between October and December 2021 at two MG centers, were enrolled. Demographics, clinical characteristics, and information regarding SARS‐CoV‐2 infection/vaccination were extracted from medical reports and/or collected throughout telephonic or in‐person interviews.

Results

Ninety‐eight (94.2%) of 104 patients included were administered at least two vaccine doses 4 weeks before the interview or earlier, and among them, 63 of 98 (64.2%) have already received the “booster” dose. The most frequently used vaccines were BNT162b2‐Pfizer‐BioNTech and mRNA‐1273‐Moderna. Overall, only minor side effects were reported, most commonly local pain and fever. MG worsening after vaccination was observed in eight of 104 (7.7%) cases. The frequency of worsening among muscle‐specific tyrosine kinase MG cases (3/9, 33.3%) was significantly higher compared to other serological subgroups. Spontaneous symptom regression was observed in six of eight cases. Twelve of 104 (11.5%) patients had SARS‐CoV‐2 infection, and none of the SARS‐CoV‐2‐infected MG patients worsened after vaccination.

Conclusions

Our data support the safety and tolerability of mRNA COVID‐19 vaccines, which should be strongly recommended in MG patients, who could be at higher risk of complications if exposed to SARS‐CoV‐2 infection.
Relationship‐undermining statements by psychotherapists with clients who present with marital or couple problems
Authors: Doherty William J. , Harris Steven M.
Published: April 2022

This study examined the prevalence of relationship undermining statements by psychotherapists as reported by clients in individual therapy who presented with relationship problems, and whether these statements were associated with worse outcomes for client relationships. Participants (n = 101) reported on recollections of whether their therapist had suggested that their partner would never change, had a diagnosable personality/mental health disorder, had negative motives, that the relationship was doomed from the start or beyond repair now, or that divorce/breakup was their best option. Findings showed high prevalence of these undermining statements and associations with poorer relationship outcomes and shorter duration of therapy. We discuss potential explanations for this phenomenon and offer implications for the training of therapists who treat individual clients with relationship problems.
What it is important to know about the effect of religious beliefs on entrepreneurial intention: The case of university students
Authors: Rodrigues Margarida , Silva Rui , Franco Mário
Published: April 2022

Entrepreneurial Intention (EI) is one of the dimensions most studied and validated scientifically in the literature associated with entrepreneurship. This study intends to go one step further in developing the literature by presenting little studied dimensions as direct antecedents of EI. Its aim is to analyse the influence of the dimensions of Religious Beliefs, Psychological and Cognitive Factors, and Social Influence on the EI of students in higher education institutions (HEI). Five hundred and eight questionnaires were collected from higher education students, 32% of them male and 68% female. The results show that the model proposed has good explanatory power and confirms its robustness in forecasting students' EI, validating all the research hypotheses with very robust and statistically significant factor loadings. This corroborates the scarce literature on the subject, especially concerning the influence of Religious Beliefs on EI.
Swahili language and literature as resources for Indian Ocean studies
Authors: Kresse Kai , Vierke Clarissa
Published: April 2022

In this contribution, our common point of convergence as an anthropologist and a literary scholar is to see Swahili language, literature and other texts as interwoven with the depth, scope, and complex dynamics of human experience and social life on the East Africa coast, with its long history of Islam. This includes prominently a view as to how this relates or is integral to the larger Indian Ocean world. Swahili language and its genres have been shaped in relation to, and in context of, transregional interaction with other languages and traditions that carry influence, and significance for the coastal residents. Ideas, thoughts, arguments and verse are taken on, adapted, mediated and disseminated flexibly by Swahili speakers through language repertoires and (mostly poetic) genres in changing media. These range from oral performances and handwritten manuscripts to booklets, CD recordings, radio programs and social media platforms.
Performance of B4C/CeB6 composites fabricated via hot pressing under different processes
Authors: Yang Chen , Wang Shuai , Wang Xingan , Sun Xudong , Xing Pengfei
Published: April 2022

In this work, CeO2 sintering additive reinforced B4C ceramic composites were prepared by hot‐pressing reaction sintering under different processes of low temperature–long holding time (1980°C, 30 MPa, 3 h, 4 wt% CeO2) and high temperature–short holding time (2050°C, 30 MPa, .5 h, 4 wt% and 6 wt% CeO2). The effect of sintering process and CeO2 content on the microstructure and mechanical properties of B4C‐CeB6 composites were investigated. The existed impurities in the obtained composites were also analyzed. Results show that CeO2 is an active sintering additive. CeB6 is formed by the reaction between CeO2, B4C and C in sintering process. The densification of B4C ceramics is enhanced, and the grains can be refined by the formed CeB6, which promotes the strength. The thermal expansion coefficient mismatch, crack deflection, and fracture mode change caused by the in situ formed CeB6 improve the toughness. The process of low temperature–long holding time is more suitable for playing the role of CeO2 additive in sintering of B4C, under which condition the relative density, flexural strength, fracture toughness, and hardness reach 99%, 417 MPa, 5.32 MPa·m1/2, and 30.66 GPa, respectively. The impurities in the composites are the kinds of Ti‐contained, C‐O‐Mg‐Ca‐contained, C‐O‐Ca‐S‐contained, and Si‐contained impurities.
Gut microbiome and prostate cancer
Authors: Fujita Kazutoshi , Matsushita Makoto , Banno Eri , De Velasco Marco A , Hatano Koji , Nonomura Norio , Uemura Hirotsugu
Published: April 2022

The gut microbiome is linked to several diseases such as Alzheimer's disease, rheumatoid arthritis, and colon cancer. The gut microbiome is also associated with the modulation of immune function, resulting in a different response to immune checkpoint therapy. The gut microbiome differs according to lifestyle, diet, sex, race, genetic background, and country. Lifestyle, especially diet, plays an important role in the development and progression of prostate cancer. Recent studies have revealed a connection between the gut microbiome and prostate cancer. A high‐fat diet causes gut dysbiosis and gut bacterial metabolites, such as short‐chain fatty acids and phospholipids that enter systemic circulation result in promoting prostate cancer growth. Additionally, the gut microbiota can serve as a source of testosterone, which affects prostate cancer progression. Men with castration‐resistant prostate cancer have an increased abundance of gut bacteria with androgenic functions. Men with high‐risk prostate cancer share a specific gut microbial profile and profiling gut microbiota could be a potentially effective tool to screen men with high‐risk prostate cancer. Lifestyle modifications can improve the gut microbiome. Furthermore, altering the gut microbiome using prebiotic or probiotic interventions may prevent or delay prostate cancer development. Further study into the “Gut–Prostate Axis” would help in the discovery of new strategies for the prevention, screening, and treatment of prostate cancer.
Mental health consumers' perspectives of physical health interventions: An integrative review
Authors: Tabvuma Tracy Samkele , Stanton Robert , Browne Graeme , Happell Brenda
Published: April 2022

Consumers of mental health services experience poor physical health compared to the general population, leading to long‐term physical illness and premature death. Current research and policy activity prioritizes the physical health of consumers yet few of these recommendations have translated to practice. This implementation gap may be influenced by the paucity of literature exploring consumer perceptions and experiences with physical healthcare and treatment. As a result, little is understood about the views and attitudes of consumers towards interventions designed to improve their physical health. This integrative review aims to explore the literature regarding consumer perspectives of physical healthcare and, interventions to improve their physical health. A systematic search was undertaken using (i) CINAHL, (ii) MEDLINE, (iii) PsycINFO, (iv) Scopus, and (v) Google Scholar between September and December 2021. Sixty‐one papers comprising 3828 consumer participants met the inclusion criteria. This review found that consumers provide invaluable insights into the barriers and enablers of physical healthcare and interventions. When consumers are authentically involved in physical healthcare evaluation, constructive and relevant recommendations to improve physical healthcare services, policy, and future research directions are produced. Consumer evaluation is the cornerstone required to successfully implement tailored physical health services.
Non‐invasive genomics of respiratory pathogens infecting wild great apes using hybridisation capture
Authors: Patrono Livia V. , Röthemeier Caroline , Kouadio Leonce , Couacy‐Hymann Emmanuel , Wittig Roman M. , Calvignac‐Spencer Sébastien , Leendertz Fabian H.
Published: April 2022

Human respiratory pathogens have repeatedly caused lethal outbreaks in wild great apes across Africa, leading to population declines. Nonetheless, our knowledge of potential genomic changes associated with pathogen introduction and spread at the human‐great ape interface remains sparse. Here, we made use of target enrichment coupled with next generation sequencing to non‐invasively investigate five outbreaks of human‐introduced respiratory disease in wild chimpanzees living in Taï National Park, Ivory Coast. By retrieving 34 complete viral genomes and three distinct constellations of pneumococcal virulence factors, we provide genomic insights into these spillover events and describe a framework for non‐invasive genomic surveillance in wildlife.
Variation of citrate to metal cation ratio for dense and phase pure BaZrO3 via autocombustion synthesis
Authors: Manju P. , Babu Ashna , S. P. Sruthy , Tirumalarao Dumpala , P. V. Abhijith , Kamble Vinayak B. , Jaiswal‐Nagar D.
Published: April 2022

In this work, we demonstrate how the metal–citrate complex structure formed in the gel reflects the true stoichiometry of the redox mixtures to yield a highly dense BaZrO3 ceramic obtained as a combustion product in the sol‐gel autocombustion technique. By systematically varying the citric acid to metal cation ratio (C/M) between 0.56, 1.0, 1.5, and 2, we show that the optimal synthesis parameters correspond to C/M ratio of 1.5, at which ratio complete chelation of citrates happen with nitrates. This was confirmed using TGA, which showed a single‐step weight loss peak corresponding to C/M =1.5 but multiple peaks in C/M ratios of 0.56 and 1. PXRD and FTIR measurements on all the burnt powders showed multiphase peaks for the C/M ratios 0.56 and 1 but only peaks corresponding to BaZrO3 for C/M = 1.5, apart from a very tiny BaCO peak. Combustion behavior of each sol‐gel corresponding to C/M ratios 0.56, 1.0, 1.5, and 2.0 is described in detail, wherein 0.56 and 1.0 sol‐gels were found to belong to the smouldering/less intense flame‐type combustion, while 1.5 and 2 belonged to the intense flame combustion, contradicting oxidant to reductant ratio (O/R) calculations that require a stoichiometric combustion for C/M ratio of 0.56 to result in an intense flame combustion. This discrepancy was explained by the optimal usage of NO ions in the gel structure corresponding to C/M ratio of 1.5 since a complete chelation of citrates to nitrates ions happen for C/M = 1.5. The observed combustion behavior, phase purity, and other characteristics of stoichiometric/ nonstoichiometric combustion products are illustrated by means of the extent of the 3D metal–citrate complex network formed as a function of C/M. The density of the sintered pellets that were sintered at a temperature of 1650C was found to be the best at 99.6 for the C/M ratio 1.5. This is the highest ever reported density for BaZrO3 ceramic demonstrating that C/M ratio of 1.5 represents that metal to cation ratio for which best chelation of citrates happen with nitrates resulting in the formation of dense BaZrO3 ceramics. A comparison of BaZrO pellet made by solid‐state synthesis technique yielded a low value of density of 97.5. Impedance spectroscopy measurements done on all BaZrO pellets yielded the lowest grain‐boundary resistance for the pellet made by the sol‐gel technique with C/M ratio of 1.5.
In situ polymerized Fe2O3@PPy/chitosan hydrogels as a hydratable skeleton for solar‐driven evaporation
Authors: Wang Jinping , Shamim Tariq , Arshad Naila , Irshad Muhammad Sultan , Mushtaq Muhammad Naveed , Zhang Chuankun , Yousaf Muhammad , Alshahrani Lina Abdullah , Akbar M. , Lu Yuzheng
Published: April 2022

The world population is severely affected by water scarcity, and it is an alarming issue that needs to be addressed urgently. Seawater desalination by solar‐driven evaporation is a promising technique to produce clean water. However, it is energy intensive and directs to a low water yield under natural sunlight. Therefore, the developments of new photothermal materials can reduce required energy for desired evaporation rates for efficient freshwater yield. Indeed, chitosan and polypyrrole‐based polymers are natural cationic copolymers, and their nanocomposites present well deal of interest for hydrogel structures due to their hydratable skeletons, and solar‐absorbing nature. Here, we report in situ polymerized Fe2O3@PPy/chitosan hydrogels as lightweight evaporation structures for solar‐powered evaporation under brine solutions (3.5 wt%). The polymeric network of Fe2O3@PPy/chitosan hydrogels builds in cross‐linked macroporous water channels, self‐floating, and a wide range of omnidirectional solar absorption (96%). The state‐of‐the‐art evaporation experiments demonstrate an efficient evaporation rate of water (1.80 kg m–2 h–1) and enhanced solar‐to‐vapor conversion efficiency (91%) as compared to other carbon‐based evaporation structures, excluding heat losses under 1 kW m–2 (one sun). Of note, the ultra‐black hydrogel surface stored enough thermal energy (39.6°C) under one sun solar irradiance due to the cationic polymeric network of Fe2O3@PPy/chitosan. A single‐step process for a freshwater supply that has been purified from various contaminants shows the potential of this device for real‐world applications.
Immersive virtual reality for increasing presence and empathy
Authors: Han Insook , Shin Hyoung Seok , Ko Yujung , Shin Won Sug
Published: April 2022

Background

Immersive VR is still rarely used as an intervention for meeting the affective end goals of student learning despite its positive impact on affection. Also, studies regarding the use of immersive VR as an intervention for affective achievement in broader educational contexts are still lacking. Objectives: This study aimed to examine the effect of immersive VR and perspective‐taking on presence and empathy.

Methods

A total of 148 pre‐service teachers participated in experiments, using either a head‐mounted display or a flat screen device to view two VR videos with different perspective‐taking affordances. This study used a mixed design with one between‐subject variable of immersion level and one within‐subject variable of perspective‐taking to explore how immersive VR experiences influenced participants’ perceived level of presence and empathy.

Results and Conclusions

The results showed that the level of immersion affects perceived presence, but it was the type of perspective‐taking that affects empathetic reactions. We also found an interaction effect between immersion levels and perspective‐taking. The direct embodiment in VR combined with high immersion produced stronger empathy than with low immersion, while the perspective of an observer was better in evoking empathy when experienced with low immersion.

Implications

This study gives a guidance on how to take advantage of this new technology in educational settings, and apply it to instructional activities to enhance students’ empathy. In addition, it could serve as a reference when developing or introducing educational contents with respect to the types of contents that are more effective in educational settings.
Influence of respiration and tissue contact on ventricular substrate identification during high density mapping: Results from an ovine infarct model
Authors: Campbell Timothy , Bennett Richard G. , Anderson Robert D. , Turnbull Samual , Kumar Saurabh
Published: April 2022

Introduction

Multielectrode mapping (MEM) and automated point collection are important enhancements to substrate mapping in ventricular tachycardia ablation. The effects of tissue contact and respiration on electrogram voltage with differing depolarization wavefronts with MEM catheters are unclear.

Methods

Bipolar and unipolar voltages were collected from control (n = 5) and infarcted (n = 7) animals with a multispline MEM catheter. Electro‐anatomic maps were created in sinus rhythm, and right and left ventricular pacing. Analysis was performed across three collections: standard settings (SS), respiratory‐phase gating (RG), and electrode‐tissue proximity (TP). Comparison was made to scar detected by cardiac MRI (cMRI).

Results

Compared to SS and RG acquisition, median bipolar and unipolar voltages were higher using TP, regardless of the depolarization wavefront. In infarct animals, bipolar voltages were 30.7%–50.5% higher for bipolar and 8.7%–13.8% higher on unipolar voltages with TP, compared to SS. The effect of RG on bipolar and unipolar voltages was minimal. Percentage of local abnormal ventricular activities was not impacted by acquisition settings or wavefront direction in infarct animals. Compared with cMRI defined scar, all three acquisition settings overestimated scar area using standard voltage‐based cutoffs. RG improved the low voltage area concordance with MRI by 1.6%–5.1% whereas TP improved by 5.9%–8.4%.

Conclusions

High density voltage mapping with a MEM catheter is influenced by point collection settings. Tissue contact filters reduced low voltage areas and improved agreement with cMRI fibrosis in infarcted ovine hearts. These findings have critical implications for optimizing filter settings for high density substrate mapping in the left ventricle.
Point‐of‐care sural nerve conduction could predict the presence of cardiovascular autonomic neuropathy in type 1 diabetes mellitus
Authors: Nattero‐Chávez Lía , Luque‐Ramírez Manuel , Quiñones‐Silva Jhonatan , Montánez Laura , Fernández‐Durán Elena , Dorado‐Avendaño Beatriz , Escobar‐Morreale Héctor F.
Published: April 2022

Aims

Assessment for cardiovascular autonomic neuropathy (CAN) in patients with type 1 diabetes mellitus remains time‐consuming in the clinical setting. We aimed to examine the diagnostic performance of a portable point‐of‐care diagnostic tool (POCD) for assessing sural nerve conduction during the screening of CAN.

Methods

Nerve amplitude (AMPPOCD) and conduction velocity (CVPOCD) were measured in a cross‐sectional study including 198 asymptomatic patients with type 1 diabetes. CAN was diagnosed by the Ewing score and power spectral heart rate [low‐frequency (LF) and high‐frequency (HF) activity]. Diagnostic accuracy was determined by ROC curves.

Results

CVPOCD and AMPPOCD showed positive correlations with LF and HF, and a negative correlation with age. Overall, AMPPOCD had an 81.7% accuracy in identifying CAN [AUC = 0.817 (95% CI 0.692–0.942)] with an AMPPOCD ≤6 μV showing 90% sensitivity and 73% specificity. In a stepwise binary logistic regression analysis, the model (R2: 0.297; P < 0.001) retained the duration of type 1 diabetes [β: 1.131 (95% CI: 1.051–1.216); P = 0.001) and A1c [β: 2.131 (95% CI: 1.060–4.283); P = 0.034) as significant predictors of CAN. The combination of AMPPOCD ≤6 μV + a type 1 diabetes duration of ≥8 years maximized the sensitivity, showing a diagnostic performance of 87% [AUC = 0.867 (95% CI 0.769–0.965)] with 90%, 76%, and 99%, sensitivity, specificity, and NPV, respectively. Adding A1c ≥ 7% to this model maintained accuracy [AUC = 0.867 (95% CI: 0.788–0.963) and NPV (99%), while increasing specificity to 84%.

Conclusions

The combination of AMPPOCD with A1c and the duration of type 1 diabetes mellitus showed a good performance for the detection of asymptomatic CAN, making POCD an easy and rapid test for its routine screening in the clinical setting.
Randomized prospective study of low‐dose isotretinoin alone and combination with salicylic acid and mandelic peel against acne tarda
Authors: Dixit Nibedita , Jena Ajaya , Panda Maitreyee , Debasmita Behera , Ipsita Debata
Published: April 2022

Background

Acne tarda (AT) is typically known as adult acne and most preferably affected 25–45 age groups. Used isotretinoid monotherapy is not effective and also produces side effects from long treatment.

Aim

The present study assesses the effectiveness of combined treatment of oral isotretinoid with topical chemical peeling (20% salicylic and 10% mandelic acid known as SM peeling) by a comparative double‐blind randomized single‐center interventional open‐label study.

Materials and Methods

A total fifty‐eight participants AT outpatients (25–45 age groups) attending for diagnosis in two groups and effectiveness of proposed combined treatments were determined at baseline and follow‐up within 4‐week interval. Briefly group A (n = 28) received 0.5 mg/kg of oral isotretinoin once daily for 16 weeks and group B (n = 30) received the same oral dose, addition with SM peeling every 4 weeks interval for 16 weeks. After 4 weeks, treatment efficacy was assessed based on Michelson's acne severity index (MASI) and visual analog scale (VAS), further validated using statistical tools.

Results

Based on MASI and VAS scores, combined treatment was significantly effective than the monotherapy. The pre‐ and post‐treatment analyses of response to scarring, inflammatory components at baseline and at the end of treatment were also statistically significant with p > 0.008.

Conclusion

The above investigation revealed that the combination of oral isotretinoin with SM peeling was highly effective and could be used as newer therapy against AT without any serious side effects.
The efficacy and tolerability of 40% pyruvic acid peel on acne vulgaris, post acne scar and hyperpigmentation in Indians
Authors: Keisham Chitralekha , Yumnam Lokendra Singh
Published: April 2022

Introduction

Pyruvic acid in concentration between 40% and 70% is currently been used as a superficial to medium peeling agent for various dermatological indications including acne. However, there is a paucity of its efficacy studies on acne in Asians, particularly in Indian skin.

Aim

Our study was aimed at determining the efficacy and tolerability of 40% pyruvic acid on acne, post‐acne hyperpigmentation, and scarring.

Materials and Methods

A total of 30 patients with active acne, post‐acne scarring, and hyperpigmentation were included. Patients already on oral antibiotic or topical antiacne medication for the last 4 weeks, a history of hypertrophic scarring, keloids, active or recurrent herpes were excluded. Chemical peeling was done at 2 weekly interval from 0 to 12 weeks. An objective assessment of active acne lesions, post‐acne scarring, and hyperpigmentation was made at each visit that is at 0, 4,8,12, and 24 weeks. Patients were followed up 2 weeks after the last peel and again at 24 weeks. Permission from the ethical committee was also obtained.

Results

There was significant decrease in the number of comedones at 12 weeks compared with 0 week (p = 0.001). Similarly, the number of papules decreased from o weeks to 12 weeks (p value 0.004). Acne score improved from 0 weeks to 12 weeks (p < 0.0001); from 0 weeks to 24 weeks (p = 0.011). and hyperpigmentation improved from 0 weeks to 12 weeks (p = 0.008); from 0 weeks to 24 weeks (p = 0.021).

Conclusion

Our study showed a significant decrease in comedones, papules, acne score, and hyperpigmentation, though acne scar did not improve significantly. However, a study with larger sample is needed due to the limited number of patient population in our study.
Factor Momentum and the Momentum Factor
Authors: EHSANI SINA , LINNAINMAA JUHANI T.
Published: April 2022

Momentum in individual stock returns relates to momentum in factor returns. Most factors are positively autocorrelated: the average factor earns a monthly return of six basis points following a year of losses and 51 basis points following a positive year. We find that factor momentum concentrates in factors that explain more of the cross section of returns and that it is not incidental to individual stock momentum: momentum‐neutral factors display more momentum. Momentum found in high‐eigenvalue principal component factors subsumes most forms of individual stock momentum. Our results suggest that momentum is not a distinct risk factor—it times other factors.
A theory of voluntary testing and self‐isolation in an ongoing pandemic
Authors: Hellmann Thomas , Thiele Veikko
Published: April 2022

Beyond Covid‐19, there is a growing interest in what economic structures will be needed to face ongoing pandemics. In this paper, we focus on the diagnostic problem and examine a new paradigm of voluntary self‐testing by private individuals. We develop a dynamic model where individuals without symptoms face daily choices of either taking the risk of going out (to work and socialize), staying at home in self‐isolation, or using a test to verify whether they are infected before going out. Our central insight is that the equilibrium public infection risk falls when home‐based testing becomes cheaper and easier to use, even if they generate both false‐positive (type I error) and false‐negative (type II error) test outcomes. We also show that the presence of naïve individuals actually reduces the equilibrium infection risk in the economy. Overall our model shows that, even if inaccurate, home‐based tests are vital for an economy facing an ongoing pandemic.
Regular dental visits, periodontitis, tooth loss, and atherosclerosis: The Ohasama study
Authors: Yamada Sho , Komiyama Takamasa , Ohi Takashi , Murakami Takahisa , Miyoshi Yoshitada , Endo Kosei , Hiratsuka Takako , Hara Azusa , Satoh Michihiro , Tatsumi Yukako , Inoue Ryusuke , Asayama Kei , Kikuya Masahiro , Hozawa Atsushi , Metoki Hirohito , Imai Yutaka , Ohkubo Takayoshi , Hattori Yoshinori
Published: April 2022

Objective

We aimed to explore the association between regular dental visits and atherosclerosis and between periodontitis, number of remaining teeth, and atherosclerosis among community dwellers in Japan.

Background

Few studies have examined the association between regular dental visits, periodontitis, tooth loss, and atherosclerosis in community dwellers in Japan.

Methods

The participants of this cross‐sectional study included community dwellers aged ≥55 years and residing in Ohasama. Exposure variables were regular dental visits; periodontitis, defined as radiographic alveolar bone loss (BL); the Centers for Disease Control/American Academy of Periodontology (CDC/AAP) classification; and number of remaining teeth. The primary outcome was atherosclerosis, defined as maximum carotid intima‐media thickness ≥1.1 mm or confirmation of atheromatous plaque.

Results

Of 602 participants, 117 had atherosclerosis. In the multivariate model, compared to those with regular dental visits, the odds ratio (OR) (95% confidence intervals [CIs]) of atherosclerosis among those with the absence of regular dental visits was 2.16 (1.03–4.49). Regarding BL‐max, compared with those in the first quartile, ORs (95% CIs) of those in the second, third, and fourth quartiles were 1.15 (0.65–2.30), 0.65 (0.32–1.35), and 1.57 (0.81–3.01), respectively. Regarding CDC/AAP classification, compared to those with no or mild periodontitis, ORs (95% CIs) for those with moderate and severe periodontitis were 2.48 (0.61–10.1) and 4.26 (1.01–17.5), respectively. Regarding the number of remaining teeth, compared to those with ≥20 teeth, ORs (95%CIs) for those with 10–19 and 1–9 teeth were 1.77 (1.004–3.12) and 0.96 (0.52–1.80), respectively.

Conclusion

The absence of regular dental visits and presence of periodontitis are associated with atherosclerosis among community dwellers in Japan.
Quantification of gastroesophageal regurgitation in brachycephalic dogs
Authors: Appelgrein Carla , Hosgood Giselle , Thompson Mary , Coiacetto Flaminia
Published: April 2022

Background

Gastroesophageal reflux and regurgitation occurs in brachycephalic dogs, but objective assessment is lacking.

Objectives

Quantify reflux in brachycephalic dogs using an esophageal pH probe and determine the association with scored clinical observations.

Animals

Fifty‐one brachycephalic dogs.

Methods

Case review study. Signs of respiratory and gastrointestinal disease severity were graded based on owner assessment. An esophageal pH probe with 2 pH sensors was placed for 18‐24 hours in brachycephalic dogs that presented for upper airway assessment. Proximal and distal reflux were indicated by detection of fluid with a pH ≤4. The median reflux per hour, percentage time pH ≤4, number of refluxes ≥5 minutes and longest reflux event for distal and proximal sensors were recorded. Association of preoperative respiratory and gastrointestinal grade, laryngeal collapse grade, and previous airway surgery with the distal percentage time pH ≤4 was examined using 1‐way ANOVA.

Results

A total of 43 of 51 dogs (84%; 95% confidence interval 72‐92) displayed abnormal reflux with a median (range) distal percentage time pH ≤4 of 6.4 (2.5‐36.1). There was no significant association between the distal percentage time pH ≤4 and respiratory grade, gastrointestinal grade, laryngeal collapse grade, or previous upper airway surgery.

Conclusions and Clinical Importance

The occurrence of reflux is not associated with owner‐assessed preoperative respiratory and gastrointestinal grade, laryngeal collapse grade, and previous airway surgery. Esophageal pH measurement provides an objective assessment tool before and after surgery.
A snapshot of progenitor–derivative speciation in Iberodes (Boraginaceae)
Authors: Otero Ana , Vargas Pablo , Fernández‐Mazuecos Mario , Jiménez‐Mejías Pedro , Valcárcel Virginia , Villa‐Machío Irene , Hipp Andrew L.
Published: April 2022

Traditional classification of speciation modes has focused on physical barriers to gene flow. Allopatric speciation with complete reproductive isolation is viewed as the most common mechanism of speciation. Parapatry and sympatry, by contrast, entail speciation in the face of ongoing gene flow, making them more difficult to detect. The genus Iberodes (Boraginaceae, NW Europe) comprises five species with contrasting morphological traits, habitats and species distributions. Based on the predominance of narrow and geographically distant endemic species, we hypothesized that geographical barriers were responsible for most speciation events in Iberodes. We undertook an integrative study including: (i) phylogenomics through restriction‐site‐associated DNA sequencing (RAD‐seq), (ii) genetic structure analyses, (iii) demographic modelling, (iv) morphometrics, and (v) climatic niche modelling and niche overlap analysis. The results revealed a history of recurrent progenitor–derivative speciation manifested by a paraphyletic pattern of nested species differentiation. Budding speciation mediated by ecological differentiation is suggested for the coastal lineage, deriving from the inland widespread Iberodes linifolia during the Late Pliocene. Meanwhile, geographical isolation followed by niche shifts are suggested for the more recent differentiation of the coastland taxa. Our work provides a model for distinguishing speciation via ecological differentiation of peripheral, narrowly endemic I. kuzinskyanae and I. littoralis from a widespread extant ancestor, I. linifolia. Ultimately, our results illustrate a case of Pliocene speciation in the probable absence of geographical barriers and get away from the traditional cladistic perspective of speciation as producing two species from an extinct ancestor, thus reminding us that phylogenetic trees tell only part of the story.
Corruption, institutional quality, and offshoring: How do they affect comparative advantage, inter‐country wage inequality, and economic growth?
Authors: Afonso Óscar , Longras Ana Rita
Published: April 2022

We analyze whether, due to the effects on corruption, institutional quality, and offshoring affect comparative advantage, income inequality between countries and economic growth. We start by developing a theoretical model of endogenous R&D growth for an integrated area with two representative countries that differ in the economic development level. Then, we estimate an econometric model with panel data, considering combinations of 14 different countries, between 2000 and 2017. We show that an improvement in offshoring increases the comparative advantage of developing‐South countries and decreases the wage gap between developed‐North and South countries. In turn, an improvement in institutional quality increases the comparative advantage of the North and widens the wage gap between countries. Whatever the improvement, there is always an increase in the world economic growth rate. Thus, all countries can improve their position in international trade, labor market, and economic growth through the conduction of policies that reduce corruption and, respectively, increase the quality of institutions and the attractiveness for the offshoring.
Maintaining health professional education during war: A scoping review
Authors: Dobiesz Valerie A. , Schwid Madeline , Dias Roger D. , Aiwonodagbon Benjamin , Tayeb Baraa , Fricke Adrienne , Pham Phuong , Erickson Timothy B.
Published: April 2022

Purpose

War negatively impacts health professional education when health care is needed most. The aims of this scoping review are to describe the scope of barriers and targeted interventions to maintaining health professional education during war and summarise the research.

Methods

We conducted a scoping review between 20 June 2018 and 2 August 2018. The search was restricted to English publications including peer‐reviewed publications without date ranges involving war and health professional education (medical school, residency training and nursing school), with interventions described to maintain educational activities. Two independent reviewers completed inclusion determinations and data abstraction. Thematic coding was performed using an inductive approach allowing dominant themes to emerge. The frequency of barrier and intervention themes and illustrative quotes were extracted. Articles were divided into modern/postmodern categories to permit temporal and historical analysis of thematic differences.

Results

Screening identified 3271 articles, with 56 studies meeting inclusion criteria. Publication dates ranged from 1914–2018 with 17 unique wars involving 17 countries. The studies concerned medical students (61.4%), residents (28.6%) and nursing students (10%). Half involved the modern era and half the postmodern era. Thematic coding identified five categories of barriers and targeted interventions in maintaining health professions education during war: curriculum, personnel, wellness, resources, and oversight, with most involving curriculum and personnel. The distribution of themes among various health professional trainees was similar. The frequency and specifics changed temporally reflecting innovations in medical education and war, with increased focus on oversight and personnel during the modern era and greater emphasis on wellness, curriculum, and resources during the postmodern era.

Conclusions

There are overarching categories of barriers and targeted interventions in maintaining health professional education during war which evolve over time. These may serve as a useful framework to strategically support future research and policy efforts.
Disagreement and suspended judgement
Authors: Ferrari Filippo
Published: April 2022

Can someone who suspends judgement about a certain proposition
 be in a relational state of disagreement with someone who believes
 as well as with someone who disbelieves
? This paper argues for an affirmative answer. It develops an account of the notions ofsuspended judgementanddisagreementthat explains how and why the suspender is in a relational state of disagreement with both the believer and the disbeliever about the very same proposition
. More specifically, the paper first provides a characterisation of the normative profile associated with the state of suspended judgement in terms of the set of normative commitments that it engenders in the context of inquiry. It then provides a characterisation of the notion of disagreement in terms the incompatibility between the sets of normative commitments characteristic of the three states in question—belief, disbelief, and suspension.
Duodenal cholinergic tuft cell number is increased in functional dyspepsia
Authors: Huang Xinyi , Oshima Tadayuki , Akiba Yasutada , Yoshimoto Takanori , Chen Junji , Taki Masato , Tomita Toshihiko , Fukui Hirokazu , Kaunitz Jonathan D. , Miwa Hiroto
Published: April 2022

Background

Low‐grade duodenal inflammation has recently been identified in patients with functional dyspepsia (FD). Chemosensory tuft cells were reported to be associated with gastrointestinal diseases. We therefore assessed duodenal tuft cell density and microinflammation in patients with FD to determine whether these measures could serve as useful biomarkers, and also correlated tuft cell density and microinflammation in FD patients.

Methods

Duodenal biopsy specimens were obtained from patients with FD and from controls. Tuft cells, eosinophils, and mast cells were immunochemically stained with specific antibodies. Tuft cells were identified by immunostaining for doublecortin‐like kinase 1 (DCLK1); cholinergic tuft cells were assessed by double staining for choline acetyltransferase (ChAT) and DCLK1. Immune‐type tuft cells were assessed by IL‐25 mRNA expression using real‐time PCR.

Key Results

The density of intramucosal eosinophils and mast cells was significantly higher in the duodenum of FD patients than in controls. The density of tuft cells was significantly higher in the duodenum of FD patients compared with controls, and significantly correlated with eosinophil density in the duodenum of FD patients and controls. Moreover, a fraction of ChAT‐positive cells was DCLK1 positive; all duodenal DCLK1+ tuft cells were ChAT‐immunoreactive in FD and in control subjects.

Conclusions and Inferences

Cholinergic tuft cell density was higher in the duodenum of patients with FD and significantly correlated with eosinophil density. Further studies are needed to investigate the pathophysiological significance of tuft cells in FD and may provide valuable clues to the pathophysiology of FD.