bluuebunny/crossref_metadata_2025 huggingface dataset:
Rapid, early and accurate SARS-CoV-2 detection using RT-qPCR in primary care: a prospective cohort study (REAP-1)
Authors: Leber Werner , Lammel Oliver , Redlberger-Fritz Monika , Mustafa-Korninger Maria Elisabeth , Glehr Reingard Christina , Camp Jeremy , Agerer Benedikt , Lercher Alexander , Popa Alexandra , Genger Jakob-Wendelin , Penz Thomas , Aberle Stephan , Bock Christoph , Bergthaler Andreas , Stiasny Karin , Hochstrasser Eva-Maria , Hoellinger Christian , Siebenhofer Andrea , Griffiths Chris , Panovska-Griffiths Jasmina
Published: August 2021

Objectives

We explore the importance of SARS-CoV-2 sentinel surveillance testing in primary care during a regional COVID-19 outbreak in Austria.

Design

Prospective cohort study.

Setting

A single sentinel practice serving 22 829 people in the ski-resort of Schladming-Dachstein.

Participants

All 73 patients presenting with mild-to-moderate flu-like symptoms between 24 February and 03 April, 2020.

Intervention

Nasopharyngeal sampling to detect SARS-CoV-2 using real-time reverse transcriptase-quantitative PCR (RT-qPCR).

Outcome measures

We compared RT-qPCR at presentation with confirmed antibody status. We split the outbreak in two parts, by halving the period from the first to the last case, to characterise three cohorts of patients with confirmed infection: early acute (RT-qPCR reactive) in the first half; and late acute (reactive) and late convalescent (non-reactive) in the second half. For each cohort, we report the number of cases detected, the accuracy of RT-qPCR, the duration and variety of symptoms, and the number of viral clades present.

Results

Twenty-two patients were diagnosed with COVID-19 (eight early acute, seven late acute and seven late convalescent), 44 patients tested SARS-CoV-2 negative and 7 were excluded. The sensitivity of RT-qPCR was 100% among all acute cases, dropping to 68.1% when including convalescent. Test specificity was 100%. Mean duration of symptoms for each group were 2 days (range 1–4) among early acute, 4.4 days (1–7) among late acute and 8 days (2–12) among late convalescent. Confirmed infection was associated with loss of taste. Acute infection was associated with loss of taste, nausea/vomiting, breathlessness, sore throat and myalgia; but not anosmia, fever or cough. Transmission clusters of three viral clades (G, GR and L) were identified.

Conclusions

RT-qPCR testing in primary care can rapidly and accurately detect SARS-CoV-2 among people with flu-like illness in a heterogeneous viral outbreak. Targeted testing in primary care can support national sentinel surveillance of COVID-19.
Comparison of efficacy and safety of His-Purkinje system pacing versus cardiac resynchronisation therapy in patients with pacing-induced cardiomyopathy: protocol for a randomised controlled trial
Authors: Chen Junjun , Cheng Liting , Wang Zefeng , Liang Zhuo , Dong Ruiqing , Hang Fei , Chen Jieruo , Wang Xinlu , Wang Ziyu , Du Xiao , Zhang Junmeng , Wu Yongquan
Published: August 2021

Introduction

Recent studies have shown that the His-Purkinje system pacing (HPSP) can achieve electrocardiomechanical synchronisation, and thus improve cardiac function. For patients with pacing-induced cardiomyopathy (PICM) who should be treated with pacemaker upgrade, the HPSP is a viable alternative to cardiac resynchronisation therapy (CRT). However, no randomised controlled trial has been performed to evaluate the efficacy and safety of HPSP in patients with PICM. The present study compared the efficacy and safety of HPSP with that of traditional CRT in the treatment of patients with PICM.

Methods and analysis

This study is a single-centre, randomised controlled non-inferiority trial. This trial was carried out at the cardiac centre of Beijing Anzhen Hospital. A total of 46 patients with PICM who needed pacemaker upgrade treatment between January 2022 and December 2023 will be enrolled in this study. Patients will be randomised into an investigational group (HPSP) and a control group (CRT) at a 1:1 ratio. The primary outcome is the duration of QRS complex (QRS width), and the secondary outcomes are NT-proBNP (N terminal pro B type natriuretic peptide), C reactive protein, the number of antibiotics used, left ventricular ejection fraction, end systolic volume, end diastolic volume, the hospitalisation duration, the incidence of postoperative infection, pacemaker parameters (threshold, sensing and impedance), the 6-minute walking test, and quality of life (36-Item Short Form Survey scale), all-cause mortality, cardiovascular death, heart failure-related rehospitalisation rate, other rehospitalisation rates, major complication rates and procedure costs.

Ethics and dissemination

This study has been approved by the Beijing Anzhen Hospital Medical Ethics Committee (No. 2020043X).

Trial registration number

Chinese Clinical Trial Registry (ChiCTR2000034265).
Long-term survival outcomes and adverse effects of nasopharyngeal carcinoma patients treated with IMRT in a non-endemic region: a population-based retrospective study
Authors: Xu Man , Zang Jian , Luo Shanquan , Wang Jianhua , Li Xuqi
Published: August 2021

Objectives

To evaluate the long-term survival outcomes and adverse effects of intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC) and to summarise the experiences of IMRT in NPC in the past few decades in non-endemic northwest China.

Design

A population-based retrospective study.

Setting

An experience of using IMRT in non-endemic region of China.

Participants

The study included 792 newly diagnosed and non-metastatic NPC patients who received IMRT from January 2006 to September 2018 in Xijing Hospital.

Outcome measures

The survival outcomes, adverse effects and failure patterns were evaluated by univariate, multivariate and subgroup analyses.

Results

With a median follow-up time of 46.2 months, the 5-year local recurrence-free survival, regional recurrence-free survival, distant metastasis-free survival, disease-free survival (DFS) and overall survival (OS) rates were 90.8%, 97.0%, 82.8%, 69.6% and 78.0%, respectively. Multivariate analysis showed that age, N stage, clinical stage, pathological type and primary tumour volume of more than 23 cm3were the independent prognosis factors for DFS (all p<0.05); age, N stage, pathological type, cervical lymph node necrosis, and anaemia were significantly associated with OS (all p<0.05). The most common acute toxicities of IMRT were dermatitis, mucositis and dysphagia. Xerostomia and hearing impairment were the top two late toxicities. The main failure patterns were distant metastasis and local and/or regional relapses.

Conclusions

Similar survival, toxicities and failure patterns have been observed in patients treated with IMRT in a non-endemic area of China when compared with that in endemic areas. Induction chemotherapy combined with concurrent chemoradiotherapy may benefit locally advanced NPC in non-endemic areas of China.
The PATCH trial: efficacy and safety of 5% lidocaine-medicated plaster for the treatment of patients with trigeminal neuralgia: a study protocol for a multicentric, double-blind, enriched enrolment randomised withdrawal, vehicle-controlled study
Authors: Zhao Chunmei , Shrestha Niti , Liu Hongbing , Shen Ying , Meng Lan , Fan Bifa , Luo Fang
Published: August 2021

Introduction

Trigeminal neuralgia (TN) is characterised by a sudden, severe, electric shock like paroxysmal pain, which is almost always associated with triggers. Carbamazepine is the first-line medical management of TN. However, side effects are common. Currently, there is no ideal treatment for TN. Since there is a known abnormality of Na+channels in the trigger zone, 5% lidocaine-medicated plaster (LMP), which can block the Na+channels on Aδ and C fibres, is an effective treatment method in many chronic pain conditions. A case report has found the benefit of LMP for the treatment of TN without any side effects. Whether LMP is an option for the treatment of TN is worth exploring.

Methods and analysis

The PATCH trial is a double-blind, enriched enrolment with randomised withdrawal, vehicle-controlled trial, aiming to explore the effects and safety of LMP in patients with TN. There is a 3-week initial open-label phase, followed by a 4-week double-blind treatment phase for responders. In the double-blind phase, patients will have to withdraw from this PATCH study if they meet one of the following criteria for treatment failure such as: >50% increase in pain intensity or paroxysms, lack of efficacy or side effects. The primary outcome will be the number of treatment failures. Adverse events will also be monitored throughout the study.

Ethics and dissemination

This study protocol has been approved by the Institutional Review Board of Beijing Tiantan Hospital (approval number: KY 2020-102-02). The results will be disseminated in international academic meetings and published in peer-reviewed journals.

Trial registration number

NCT04570293.
Study protocol for a mixed methods exploratory investigation of aftercare services for gestational diabetes in women to develop a new patient-centred model in Germany: the GestDiNa_basic study
Authors: Greiner Gregory Gordon , Viehmann Anja , Linnenkamp Ute , Wilm Stefan , Leve Verena , Neuenschwander Manuela , Kuss Oliver , Fehm Tanja , Ensenauer Regina , Schumacher Liesa , Lange Ute , Müller-Bößmann Dorit , Lappe Veronika , Ihle Peter , Adamczewski Heinke , Kaltheuner Matthias , Tamayo Miguel , Gräfe Viola , Westerhoff Benjamin , Wallerich-Herf Nadine , Schellhammer Stefanie , Kerres Thomas , Schmitz-Losem Imke , Cramer Stefan , Rupprecht Christoph J , Klüppelholz Birgit , Meyer Frank , Koch-Schulte Simone , Jüngling Ute ,   GestDiNa study group, Icks Andrea
Published: August 2021

Introduction

Women with gestational diabetes mellitus (GDM) have a higher risk of developing type 2 diabetes mellitus compared with women who never had GDM. Consequently, the question of structured aftercare for GDM has emerged. In all probability, many women do not receive care according to the guidelines. In particular, the process and interaction between obstetrical, diabetic, gynaecological, paediatric and general practitioner care lacks clear definitions. Thus, our first goal is to analyse the current aftercare situation for women with GDM in Germany, for example, the participation rate in aftercare diabetes screening, as well as reasons and attitudes stated by healthcare providers to offer these services and by patients to participate (or not). Second, we want to develop an appropriate, effective and patient-centred care model.

Methods and analysis

This is a population-based mixed methods study using both quantitative and qualitative research approaches. In various working packages, we evaluate data of the GestDiab register, of the Association of Statutory Health Insurance Physicians of North Rhine and the participating insurance companies (AOK Rheinland/Hamburg, BARMER, DAK Gesundheit, IKK classic, pronova BKK). In addition, quantitative (postal surveys) and qualitative (interviews) surveys will be conducted with randomly selected healthcare providers (diabetologists, gynaecologists, paediatricians and midwives) and affected women, to be subsequently analysed. All results will then be jointly examined and evaluated.

Ethics and dissemination

The study was approved by the ethics committee of the Faculty of Medicine, Heinrich-Heine-University Düsseldorf (Ethics Committee No.: 2019-738). Participants of the postal surveys and interviews will be informed in detail about the study and the use of data as well as the underlying data protection regulations before voluntarily participating. The study results will be disseminated through peer-reviewed journals, conferences and public information.

Trial registration number

DRKS00020283.
The Daily Mile in practice: implementation and adaptation of the school running programme in a multiethnic city in the UK
Authors: Routen Ash , Gonzalez Aguado Maria , O' Connell Sophie , Harrington Deirdre
Published: August 2021

Objectives

The aim of this study was to generate new evidence on how The Daily Mile (TDM), a popular school-based running programme in the UK, is implemented in a diverse and multiethnic city in the UK and also the barriers faced by non-implementer schools.

Design

Mixed method cross-sectional study (including survey data collection and qualitative interviews).

Setting

Primary schools in a multiethnic city in the East Midlands, UK.

Participants

Forty-two schools in Leicester city completed an online survey, and five teaching staff from five schools took part in follow-up semistructured qualitative interviews.

Results

Overall, 40.5% of schools who completed the survey reported having never implemented TDM, and 96.0% of implementer schools reported delivering TDM on three or more days per week. Reported barriers included space limitations and safety issues, timetabling and curriculum pressures, and pupil and teacher attitudes. Facilitators of implementation were teacher engagement and school culture/ethos, communication of the initiative and substantial delivery adaptations.

Conclusions

The findings from this study, based on data from schools in a multiethnic city in the UK, suggest that implementation of TDM is variable, and is influenced by a range of factors related to the school context, as well as the characteristics of TDM itself.
Complex multimorbidity and mortality in Japan: a prospective propensity-matched cohort study
Authors: Kato Daisuke , Kawachi Ichiro , Saito Junko , Kondo Naoki
Published: August 2021

Objectives

There are limitations to defining multimorbidity (MM) based on a simple count of diseases. To address these limitations, the concept of complex MM (CMM) focuses on how many body systems are affected in a single patient, rather than counting comorbid conditions. This study compared the prediction of mortality among older Japanese adults between CMM and conventional MM.

Design

A population-based prospective cohort study.

Setting

The Japan Gerontological Evaluation Study, a nationwide longitudinal cohort study, which ran from 2010 to 2016.

Participants

Functionally independent individuals who were older than 65 and had complete illness data at the time of baseline survey were eligible.

Outcomes measure

CMM was defined as the coexistence of 3 or more body system disorders at baseline. We calculated the propensity for each individual to develop CMM based on a wide array of characteristics, including socioeconomic status and health behaviours. Individuals with and without CMM were then matched on their propensity scores before we estimated overall survival using a log-rank test.

Results

Our 6-year follow-up included 38 889 older adults: 20 233 (52.0%) and 7565 (19.5%) adults with MM and CMM, respectively. In the MM-matched cohort (n=15 666 pairs), the presence of MM was significantly associated with increased mortality (HR 1.07; 95% CI 1.01 to 1.14; p=0.02 by the log-rank test). A similar mortality association was found in the CMM-matched cohort (n=7524 pairs, HR, 1.07; 95% CI 0.99 to 1.16; p=0.08 by the log-rank test).

Conclusion

This is the first study to report the association between CMM and mortality among older adults in Japan. MM and CMM predict mortality in older adults to a similar degree. This finding needs to be replicated with more precision in larger samples.
Economic evaluation of the Midwifery Initiated Oral Health-Dental Service programme in Australia
Authors: Tannous Kathy W , George Ajesh , Ahmed Moin Uddin , Blinkhorn Anthony , Dahlen Hannah G , Skinner John , Ajwani Shilpi , Bhole Sameer , Yaacoub Albert , Srinivas Ravi , Johnson Maree
Published: August 2021

Objectives

To critically evaluate the cost-effectiveness of the Midwifery Initiated Oral Health-Dental Service (MIOH-DS) designed to improve oral health of pregnant Australian women. Previous efficacy and process evaluations of MIOH-DS showed positive outcomes and improvements across various measures.

Design and setting

The evaluation used a cost-utility model based on the initial study design of the MIOH-DS trial in Sydney, Australia from the perspective of public healthcare provider for a duration of 3 months to 4 years.

Participants

Data were sourced from pregnant women (n=638), midwives (n=17) and dentists (n=3) involved in the MIOH trial and long-term follow-up.

Cost measures

Data included in analysis were the cost of the time required by midwives and dentists to deliver the intervention and the cost of dental treatment provided. Costs were measured using data on utilisation and unit price of intervention components and obtained from a micro-costing approach.

Outcome measures

Utility was measured as the number of Disability Adjusted Life Years (DALYs) from health-benefit components of the intervention. Three cost-effectiveness analyses were undertaken using different comparators, thresholds and time scenarios.

Results

Compared with current practice, midwives only intervention meets the Australian threshold (A$50 000) of being cost-effective. The midwives and accessible/affordable dentists joint intervention was only ‘cost-effective’ in 6 months or beyond scenarios. When the midwife only intervention is the comparator, the midwife/dentist programme was ‘cost-effective’ in all scenarios except at 3 months scenario.

Conclusions

The midwives’ only intervention providing oral health education, assessment and referral to existing dental services was cost-effective, and represents a low cost intervention. Midwives’ and dentists’ combined interventions were cost-effective when the benefits were considered over longer periods. The findings highlight short and long term economic benefits of the programme and support the need for policymakers to consider adding an oral health component into antenatal care Australia wide.

Trial registration number

ACTRN12612001271897; Post-results.
Comparison of immediate postpartum contraception among women with a high versus low risk pregnancy in Mexico: a retrospective cohort study
Authors: Powell Jacqueline , Fuentes-Rivera Evelyn , Darney Blair
Published: August 2021

Objective

We tested whether women who reported high-risk pregnancies or deliveries were more likely to receive immediate postpartum contraception prior to discharge compared with normal-risk women in Mexico.

Methods

This is a retrospective study using the National Health and Nutrition Survey. We classified women as high-risk based on reported complications in pregnancy and delivery. We used multivariable logistic regression to test the association of high-risk status and receipt of postpartum contraception (any modern method and Tier one methods) prior to discharge.

Results

Our sample included 5030 deliveries (population N=3 923 657). Overall, 19.1% of the sample were high risk. Over 60% of women in the high-risk and normal-risk group received immediate postpartum contraception, but a greater proportion of high-risk women received a method (67% vs 61% normal risk; p<0.001). However, in multivariable models, there were no significant differences in receipt of any modern method or tier 1 method by risk group.

Conclusion

Women with high-risk pregnancies were not more likely to receive postpartum contraception than the normal-risk group, once accounting for sociodemographic and clinical factors. Prenatal and postpartum contraception counselling should address the health effects of high-risk pregnancies and interpregnancy intervals to improve maternal health outcomes.
Reporting standards, outcomes and costs of quality improvement studies in Ireland: a scoping review
Authors: McCarthy Siobhán Eithne , Jabakhanji Samira Barbara , Martin Jennifer , Flynn Maureen Alice , Sørensen Jan
Published: August 2021

Objectives

To profile the aims and characteristics of quality improvement (QI) initiatives conducted in Ireland, to review the quality of their reporting and to assess outcomes and costs.

Design

Scoping review.

Data sources

Systematic searches were conducted in PubMed, Web of Science, Embase, Google Scholar, Lenus and rian.ie. Two researchers independently screened abstracts (n=379) and separately reviewed 43 studies identified for inclusion using a 70-item critique tool. The tool was based on the Quality Improvement Minimum Quality Criteria Set (QI-MQCS), an appraisal instrument for QI intervention publications, and health economics reporting criteria. After reaching consensus, the final dataset was analysed using descriptive statistics. To support interpretations, findings were presented at a national stakeholder workshop.

Eligibility criteria

QI studies implemented and evaluated in Ireland and published between January 2015 and April 2020.

Results

The 43 studies represented various QI interventions. Most studies were peer-reviewed publications (n=37), conducted in hospitals (n=38). Studies mainly aimed to improve the ‘effectiveness’ (65%), ‘efficiency’ (53%), ‘timeliness’ (47%) and ‘safety’ (44%) of care. Fewer aimed to improve ‘patient-centredness’ (30%), ‘value for money’ (23%) or ‘staff well-being’ (9%). No study aimed to increase ‘equity’. Seventy per cent of studies described 14 of 16 QI-MQCS dimensions. Least often studies reported the ‘penetration/reach’ of an initiative and only 35% reported health outcomes. While 53% of studies expressed awareness of costs, only eight provided at least one quantifiable figure for costs or savings. No studies assessed the cost-effectiveness of the QI.

Conclusion

Irish QI studies included in our review demonstrate varied aims and high reporting standards. Strategies are needed to support greater stimulation and dissemination of QI beyond the hospital sector and awareness of equity issues as QI work. Systematic measurement and reporting of costs and outcomes can be facilitated by integrating principles of health economics in QI education and guidelines.
Diagnosis and management of cardiac allograft vasculopathy
Authors: Ortega-Legaspi Juan M , Bravo Paco E
Published: August 2021

One of the main causes of death beyond the first year after heart transplantation is cardiac allograft vasculopathy (CAV). This review summarises the current understanding of its complex pathophysiology, detection and treatment, including the available data on non-invasive imaging modalities used for screening and diagnosis. A better understanding of this entity is crucial to improving the long-term outcomes of the growing population of patients with a heart transplant.
Non-vitamin K antagonist oral anticoagulants, proton pump inhibitors and gastrointestinal bleeds
Authors: Komen Joris , Pottegård Anton , Hjemdahl Paul , Mantel-Teeuwisse Aukje K , Wettermark Björn , Hellfritzsch Maja , Hallas J , Herings Ron , Smits Lisa , Forslund Thomas , Klungel Olaf
Published: August 2021

Objective

To evaluate if proton pump inhibitor (PPI) treatment reduces the risk of upper gastrointestinal bleeding (UGIB) in patients with atrial fibrillation (AF) treated with non-vitamin K antagonist oral anticoagulants (NOACs).

Design

We used a common protocol, common data model approach to conduct a cohort study including patients with AF initiated on a NOAC in Stockholm, Denmark and the Netherlands from April 2011 until July 2018. The outcome of interest was a UGIB diagnosed in a secondary care inpatient setting. We used an inverse probability weighted (IPW) Poisson regression to calculate incidence rate ratios (IRRs), contrasting PPI use to no PPI use periods.

Results

In 164 290 NOAC users with AF, providing 272 570 years of follow-up and 39 938 years of PPI exposure, 806 patients suffered a UGIB. After IPW, PPI use was associated with lower UGIB rates (IRR: 0.75; 95% CI: 0.59 to 0.95). On an absolute scale, the protective effect was modest, and was found to be largest in high-risk patients, classified as age 75–84 years (number needed to treat for 1 year (NNTY): 787), age ≥85 years (NNTY: 667), HAS-BLED score ≥3 (NNTY: 378) or on concomitant antiplatelet therapy (NNTY: 373).

Conclusion

Concomitant treatment with a PPI in NOAC-treated patients with AF is associated with a reduced risk of severe UGIB. This indicates that PPI cotreatment can be considered, in particular among the elderly patients, patients with a HAS-BLED score ≥3, and/or in patients on concomitant antiplatelet therapy.
Association between community-level social capital and frailty onset among older adults: a multilevel longitudinal study from the Japan Gerontological Evaluation Study (JAGES)
Authors: Noguchi Taiji , Murata Chiyoe , Hayashi Takahiro , Watanabe Ryota , Saito Masashige , Kojima Masayo , Kondo Katsunori , Saito Tami
Published: August 2021

Background

Little is known about the prospective association between community-level social capital and individual-level frailty onset. Therefore, this study aimed to examine the impact of community-level social capital on frailty onset among older adults using 3-year longitudinal data.

Methods

This prospective cohort study recruited non-institutionalised older adults from the Japan Gerontological Evaluation Study, established in 2013 and robust older adults were followed up for 3 years. We assessed three aspects of community-level social capital (civic participation, social cohesion and reciprocity), and employed a multilevel logistic regression analysis; frailty was evaluated using the Kihon Checklist questionnaire, which has been widely used as a screening tool for frailty in Japan.

Results

In total, 21 940 older adults (from 384 communities) who were robust at baseline (2013) completed the follow-up survey (2016). Participants’ mean age (SD) was 71.8 (4.9) years, and 51.2% were female. In the follow-up period, frailty onset occurred in 622 participants (2.8%). Regarding community-level social capital variables, civic participation was inversely associated with frailty onset (OR=0.94, 95% CI 0.90 to 0.97, p=0.001), after adjusting for individual-level and community-level covariates. The potential intermediate factors of individual social relationships and health behaviours did not largely change the results. This association was found regardless of individual socioeconomic status.

Conclusions

Living in a community with rich civic participation, such as engagement in social activities, was associated with lower frailty onset among older adults. Community development that fosters social participation is essential for frailty prevention.
Prevalence and Predictors of Colonoscopic Findings in Patients with Autoimmune Gastritis
Authors: Asfuroglu Kalkan Emra , Kalkan Cagdas , Gumussoy Mesut , Gucbey Ozge , Soykan Irfan
Published: August 2021

The clinical spectrum of autoimmune gastritis is silent in the early stages of the disease and no specific symptom is related to this entity. Although gastroscopic findings of this entity are well defined, data regarding colonoscopic findings are limited. The aims of this study were to determine the prevalence of colonoscopic findings and to explore factors that might affect these findings. This is a retrospective chart review of patients with autoimmune gastritis (n=240). Data regarding colonoscopic findings, serum gastrin and chromogranin A (CgA) levels and gastric histopathological results were extracted and compared with 550 patients positive for Helicobacter pylori and gastric atrophy. Control subjects had colonoscopy and gastroscopy with biopsies. Colorectal lesions were observed in 64 (26.6%) of patients with autoimmune gastritis and 36 (6.6%) patients had colorectal lesions in the control group (p<0.001). Serum gastrin (OR: 8.59, 95% CI 1.72 to 25.07, p<0.001) and CgA levels (OR: 6.79, 95% CI 0.41 to 27.26, p<0.001) were found as factors affecting the presence of colorectal carcinoma. Serum gastrin and CgA levels were also found as predictors for the presence of colorectal adenomas. There is a higher prevalence of colorectal neoplastic lesions in patients with autoimmune gastritis. Serum gastrin and CgA levels were found to be determinants of colorectal neoplastic lesions observed in patients. In the workup of these patients, serum gastrin and CgA levels may guide physicians for the demonstration of colorectal neoplastic lesions.
Longitudinal changes of spinal cord grey and white matter following spinal cord injury
Authors: David Gergely , Pfyffer Dario , Vallotton Kevin , Pfender Nikolai , Thompson Alan , Weiskopf Nikolaus , Mohammadi Siawoosh , Curt Armin , Freund Patrick
Published: August 2021

Objectives

Traumatic and non-traumatic spinal cord injury produce neurodegeneration across the entire neuraxis. However, the spatiotemporal dynamics of spinal cord grey and white matter neurodegeneration above and below the injury is understudied.

Methods

We acquired longitudinal data from 13 traumatic and 3 non-traumatic spinal cord injury patients (8–8 cervical and thoracic cord injuries) within 1.5 years after injury and 10 healthy controls over the same period. The protocol encompassed structural and diffusion-weighted MRI rostral (C2/C3) and caudal (lumbar enlargement) to the injury level to track tissue-specific neurodegeneration. Regression models assessed group differences in the temporal evolution of tissue-specific changes and associations with clinical outcomes.

Results

At 2 months post-injury, white matter area was decreased by 8.5% and grey matter by 15.9% in the lumbar enlargement, while at C2/C3 only white matter was decreased (−9.7%). Patients had decreased cervical fractional anisotropy (FA: −11.3%) and increased radial diffusivity (+20.5%) in the dorsal column, while FA was lower in the lateral (−10.3%) and ventral columns (−9.7%) of the lumbar enlargement. White matter decreased by 0.34% and 0.35% per month at C2/C3 and lumbar enlargement, respectively, and grey matter decreased at C2/C3 by 0.70% per month.

Conclusions

This study describes the spatiotemporal dynamics of tissue-specific spinal cord neurodegeneration above and below a spinal cord injury. While above the injury, grey matter atrophy lagged initially behind white matter neurodegeneration, in the lumbar enlargement these processes progressed in parallel. Tracking trajectories of tissue-specific neurodegeneration provides valuable assessment tools for monitoring recovery and treatment effects.
Anti-CD20 therapies decrease humoral immune response to SARS-CoV-2 in patients with multiple sclerosis or neuromyelitis optica spectrum disorders
Authors: Louapre Céline , Ibrahim Michella , Maillart Elisabeth , Abdi Basma , Papeix Caroline , Stankoff Bruno , Dubessy Anne-Laure , Bensa-Koscher Caroline , Créange Alain , Chamekh Zina , Lubetzki Catherine , Marcelin Anne-Geneviève , Corvol Jean-Christophe , Pourcher Valérie
Published: August 2021

Background

SARS-CoV-2 seroconversion rate after COVID-19 may be influenced by disease-modifying therapies (DMTs) in patients with multiple sclerosis (MS) or neuromyelitis optica spectrum disorders (NMO-SD).

Objective

To investigate the seroprevalence and the quantity of SARS-CoV-2 antibodies in a cohort of patients with MS or NMO-SD.

Methods

Blood samples were collected in patients diagnosed with COVID-19 between 19 February 2020 and 26 February 2021. SARS-CoV-2 antibody positivity rates and Ig levels (anti-S IgG titre, anti-S IgA index, anti-N IgG index) were compared between DMTs groups. Multivariate logistic and linear regression models were used to estimate the influence of DMTs and other confounding variables on SARS-CoV-2 serological outcomes.

Results

119 patients (115 MS, 4 NMO, mean age: 43.0 years) were analysed. Overall, seroconversion rate was 80.6% within 5.0 (SD 3.4) months after infection. 20/21 (95.2%) patients without DMT and 66/77 (85.7%) patients on DMTs other than anti-CD20 had at least one SARS-CoV-2 Ig positivity, while this rate decreased to only 10/21 (47.6%) for patients on anti-CD20 (p<0.001). Being on anti-CD20 was associated with a decreased odd of positive serology (OR, 0.07 (95% CI 0.01 to 0.69), p=0.02) independently from time to COVID-19, total IgG level, age, sex and COVID-19 severity. Time between last anti-CD20 infusion and COVID-19 was longer (mean (SD), 3.7 (2.0) months) in seropositive patients compared with seronegative patients (mean (SD), 1.9 (1.5) months, p=0.04).

Conclusions

SARS-CoV-2 antibody response was decreased in patients with MS or NMO-SD treated with anti-CD20 therapies. Monitoring long-term risk of reinfection and specific vaccination strategies in this population may be warranted.

Trial registration number

NCT04568707.
Broad concepts and messy realities: optimising the application of mental capacity criteria
Authors: Kim Scott Y H , Kane Nuala B , Ruck Keene Alexander , Owen Gareth S
Published: August 2021

Most jurisdictions require that a mental capacity assessment be conducted using a functional model whose definition includes several abilities. In England and Wales and in increasing number of countries, the law requires a person be able to understand, to retain, to use or weigh relevant information and to communicate one’s decision. But interpreting and applying broad and vague criteria, such as the ability ‘to use or weigh’ to a diverse range of presentations is challenging. By examining actual court judgements of capacity, we previously developed a descriptive typology of justifications (rationales) used in the application of the Mental Capacity Act (MCA) criteria. We here critically optimise this typology by showing how clear definitions—and thus boundaries—between the criteria can be achieved if the ‘understanding’ criterion is used narrowly and the multiple rationales that fall under the ability to ‘use or weigh’ are specifically enumerated in practice. Such a typology-aided practice, in theory, could make functional capacity assessments more transparent, accountable, reliable and valid. It may also help to create targeted supports for decision making by the vulnerable. We also discuss how the typology could evolve legally and scientifically, and how it lays the groundwork for clinical research on the abilities enumerated by the MCA.
Non-relativistic quark model under external magnetic and Aharanov–Bohm (AB) fields in the presence of temperature-dependent confined Cornell potential
Authors: Abu-Shady M. , Edet C.O. , Ikot A.N.
Published: August 2021

The dissociation of quarkonia in a thermal QCD medium in the background of Aharanov–Bohm (AB) and strong magnetic fields was investigated. For this purpose, the Schrödinger equation with charged quarkonium in the Cornell potential under the influence of the AB flux and an external magnetic fields directed along the z-axis was employed. Using the Nikiforov–Uvarov (NU) method, the energy eigenvalue was obtained. The effects of temperature, AB flux, and external magnetic field were studied. The study shows that the dissociation energies of the 1S states of charmonium and bottomonium decrease with increasing temperature, AB flux, and external magnetic field. In addition, the quarkonium melts faster in a hot medium in the presence of an AB flux and an external magnetic field. We found that charmonium melts at 13.79 [Formula: see text] and bottomonium melts at 99.48 [Formula: see text]. A comparison was conducted with other studies. Thus, the present non-relativistic model provides satisfactory results for the dissociation binding energy in a hot medium when the AB flux and external magnetic fields are included.
Derivation of general relativistic gravitational potential energy using principle of equivalence and gravitational time dilation
Authors: Dikshit Biswaranjan
Published: August 2021

Einstein’s theory of general relativity, which has been experimentally proved to be a true theory of gravity does not need gravitational potential energy to predict the trajectory of particles in space. This is because general relativity is a purely geometric theory. Objects move along the geodesics in the curved space–time. The energy–momentum tensor that warps space–time as per Einstein’s field equations takes into account only the energy–momentum of matter and radiation. Thus, gravitational potential energy does not come into the picture in Einstein’s theory of gravity and its role is taken over by the curvature of space–time. However, a general relativistically correct expression for gravitational potential energy is required for energy conservation and some energy-based approaches in physics. Conventionally, the correct form of gravitational potential energy is derived by using the full mathematical formality of general relativity. In this paper, we derive the same general relativistic expression for gravitational potential energy simply by using the principle of equivalence and gravitational time dilation.
Experimental consolidation and absolute measurement of the $$^\text {nat}$$C(p,x)$$^{11}$$C nuclear activation cross section at 100 MeV for particle therapy physics
Authors: Bäcker Claus Maximilian , Horst Felix , Adi Wihan , Bäumer Christian , Gerhardt Marcel , Jentzen Walter , Kazek Sandra Laura , Kröninger Kevin , Schuy Christoph , Verbeek Nico , Weingarten Jens , Wulff Jörg , Timmermann Beate
Published: August 2021

The $$^\text {nat}$$

nat

C(p,x)$$^{11}$$

11

C reaction has been discussed in detail in the past [EXFOR database, Otuka et al. (Nuclear Data Sheets 120:272–276, 2014)]. However, measured activation cross sections by independent experiments are up to 15% apart. The aim of this study is to investigate underlying reasons for these observed discrepancies between different experiments and to determine a new consensus reference cross section at 100 MeV. Therefore, the experimental methods described in the two recent publications [Horst et al. (Phys Med Biol https://doi.org/10.1088/1361-6560/ab4511, 2019) and Bäcker et al. (Nuclear Instrum Methods Phys Res B 454:50–55, 2019)] are compared in detail and all experimental parameters are investigated for their impact on the results. For this purpose, a series of new experiments is performed. With the results of the experiments a new reference cross section of (68±3) mb is derived at (97±3) MeV proton energy. This value combined with the reliably measured excitation function could provide accurate cross section values for the energy region of proton therapy. Because of the well-known gamma-ray spectrometer used and the well-defined beam characteristics of the treatment machine at the proton therapy center, the experimental uncertainties on the absolute cross section could be reduced to 3%. Additionally, this setup is compared to the in-beam measurement setup from the second study presented in the literature (Horst et al. 2019). Another independent validation of the measurements is performed with a PET scanner.
A MULTI-FIELD COUPLED SEEPAGE MODEL FOR COAL SEAM WITH FRACTURES OF POWER LAW LENGTH DISTRIBUTIONS
Authors: LIU GUANNAN , HU YUHAO , YU BOMING , GAO FENG , YUE FENGTIAN , GAO TAO
Published: August 2021

In the process of gas mining, the fracture distribution with power law length and the pore structure with adsorption effect have an important influence on the coal seam permeability. In recent years, the research on the internal structure of coal seam and the fluid flow mechanism has attracted a large number of researchers. In this paper, by considering the coal matrix deformation caused by adsorption, a pore-fracture model coupled with the multi-field effects and with power law length distribution of fractures in coal seam is established based on the fractal theory for porous media. In this work, we study the influences of the power law exponent [Formula: see text] of fracture length and the ratio [Formula: see text] of the minimum to maximum fracture lengths on the permeability of coal seam and the evolution mechanism of permeability with the structural and mechanical parameters of coal seam. It is found that the permeability of coal seam is inversely proportional to [Formula: see text], directly proportional to [Formula: see text], and to Langmuir volume constant and Langmuir volume strain constant. Compared with other factors, the power law component [Formula: see text] of fractures has the most significant effect on the coal seam permeability.
Mimicry
Authors: Wu Ziwei , Huang Lingdong
Published: August 2021

The authors have collaborated on a machine learning multiscreen video installation powered by computer algorithms and inspired by mimicry in the natural world. The artwork explores a pseudo-environment loop system in nature and artificial mechanical organisms combining living flowers with projectors, webcams, and computer monitors. Technically, the software adopts a genetic algorithm to simulate the process of mimicry; conceptually, this real-time art installation is in conversation with Nam June Paik's piece TV Garden. The project explores the possibilities of integrating artificial intelligence and nature in the landscape of the future.
Imaginary Stroke Movement Measurement and Visualization
Authors: Lyu Ruimin , Zhang Tianqin , Yuan Zhaolin
Published: August 2021

When viewing visual artworks, one can feel the suggestive movement from the brushstrokes. This phenomenon has been recorded widely in literature on art theory, and its physiological basis has been found in neuroaesthetic studies, but there is no method to measure its details at present. In this paper, two experiments are designed to measure the velocity sense and the trace sense, which are the instantaneous and cumulative representations of the same content---the kinetic feeling of strokes, respectively. Furthermore, various visualizations are designed for the two kinds of experimental data as artistic recreation of traditional artworks. In addition, the quantitative analysis is performed on the imaginary stroke movement, showing that imaginary stroke movement can be studied by mathematics.
Recent Research on the Archaeology of War and Violence
Authors: Scherer Andrew K.
Published: August 2021

The mid-1990s through the first decade of the new millennium marked an increase in publications pertaining to war and violence in the ancient past. This review considers how scholars of the past decade have responded to that work. The emerging consensus is that war and violence were endemic to all societies studied by archaeologists, and yet the frequency, intensity, causes, and consequences of violence were highly variable for reasons that defy simplistic explanation. The general trend has been toward archaeologies of war and violence that focus on understanding the nuances of particular places and historical moments. Nevertheless, archaeologists continue to grapple with grand narratives of war, such as the proposition that violence has decreased from ancient to modern times and the role of war and violence in state formation and collapse. Recent research also draws attention to a more expansive definition of violence.
Financial Architecture and Financial Stability
Authors: Allen Franklin , Walther Ansgar
Published: August 2021

This article studies the links between financial stability and the architecture of financial systems. We review the existing literature and provide organizing frameworks for analyzing three empirically important aspects of financial architecture: the rise of nonbank financial intermediaries, the regulatory response to these structural changes, and the emergence of complex interbank networks. One of our main new results is a necessary and sufficient condition for whether nonbank intermediaries are immune to runs in an extended version of the Diamond–Dybvig model.
Photonic Stopband Tuning in Metallo-Dielectric Photonic Crystals
Authors: Lonergan Alex , Murphy Breda , O’Dwyer Colm
Published: August 2021

One of the most appealing aspects of photonic crystal structures is the photonic bandgap created in structures with sufficiently high dielectric contrasts between constituent materials. Periodic structures with a modest dielectric contrast between high and low index regions instead form a photonic stopband; the photonic stopband is linked to the principal diffraction resonance from the (111) crystal plane in the photonic crystal. Understanding how specific photonic crystal structures and their associated stopband positions can selectively interfere with incoming light is vital for implementing these structured dielectrics in a range of optical applications. Among the many methods existing to modify the signature optical response of photonic crystal materials, metallo-dielectric photonic crystals act to incorporate metal particles into the ordered arrangement of these structures. We examined the optical changes to the transmission spectrum resulting from copper, nickel and gold metal infiltration into polystyrene opals and TiO2 inverse opals. We report a consistent and interesting optical phenomena directly associated with the creation of metallo-dielectric photonic crystal structures. More pronounced and numerous diffraction resonances emerge in opal photonic crystals with a metal deposited across the top layer. Common to both opal and inverse opal structures, was a blue-shift in the position of the (111) photonic stopband which increased in magnitude with greater metal content in the structure. We investigate the origin of the photonic stopband blue-shift by variation of the metal content and the placement of metal in the photonic crystal structure. Our results suggest that metal introduced to structured dielectric media acts to tune the position of the photonic stopband by slight alterations to the effective dielectric constant or effective refractive index of the photonic crystal material.
Intestinal alteration of α-gustducin and sweet taste signaling pathway in metabolic diseases is partly rescued after weight loss and diabetes remission
Authors: Le Gléau Léa , Rouault Christine , Osinski Céline , Prifti Edi , Soula Hédi Antoine , Debédat Jean , Busieau Pauline , Amouyal Chloé , Clément Karine , Andreelli Fabrizio , Ribeiro Agnès , Serradas Patricia
Published: August 2021

Our data highlighted 1) the sweet taste transduction pathway in EECs plays pivotal role for glucose homeostasis at least at gene expression level; 2) metabolic disorders led to altered gene expression of sweet taste signaling pathway in intestine contributing to impaired GLP-1 secretion; and 3) after surgical intestinal modifications, increased expression of α-gustducin contributed to metabolic improvement.
β-Cell autophagy in the pathogenesis of type 1 diabetes
Authors: Muralidharan Charanya , Linnemann Amelia K.
Published: August 2021

Type 1 diabetes is an insulin-dependent, autoimmune disease where the pancreatic β cells are destroyed resulting in hyperglycemia. This multifactorial disease involves multiple environmental and genetic factors, and has no clear etiology. Accumulating evidence suggests that early signaling defects within the β cells may promote a change in the local immune milieu leading to autoimmunity. Therefore, many studies have been focused on intrinsic β-cell mechanisms that aid in the restoration of cellular homeostasis under environmental conditions that cause dysfunction. One of these intrinsic mechanisms to promote homeostasis is autophagy, defects which are clearly linked with β-cell dysfunction in the context of type 2 diabetes. Recent studies have now also pointed towards β-cell autophagy defects in the context of type 1 diabetes. In this perspectives review, we will discuss the evidence supporting a role for β-cell autophagy in the pathogenesis of type 1 diabetes, including a potential role for unconventional secretion of autophagosomes/lysosomes in the changing dialogue between the β cell and immune cells.
Patterns of differentiation of renin lineage cells during nephrogenesis
Authors: Kessel Friederike , Steglich Anne , Hickmann Linda , Lira Martinez Ricardo , Gerlach Michael , Sequeira-Lopez Maria Luisa S. , Gomez R. Ariel , Hugo Christian P. M. , Todorov Vladimir T.
Published: August 2021

The unifying feature of the renal renin lineage cells (RLCs) is their origin from renin-expressing progenitors. RLCs evolve to an embryologically heterogeneous large population in structures with different ancestry. RLCs are also targets for the widely used renin-angiotensin-system blockers, which modulate their phenotype. Unveiling the different differentiation patterns of RLCs in the developing kidney contributes to understanding changes in their cell fate in response to homeostatic challenges and the use of antihypertensive drugs.