bluuebunny/crossref_metadata_2025 huggingface dataset:
Women’s experiences of over-the-counter and prescription medication during pregnancy in the UK: findings from survey free-text responses and narrative interviews
Authors: Sanders Julia , Blaylock Rebecca , Dean Caitlin , Petersen Irene , Trickey Heather , Murphy Clare
Published: March 2023

Objectives

To explore women’s experiences of over-the-counter and prescription medication advice and use during pregnancy.

Design

A study design consisting of an online survey and nested in-depth interviews with a subsample of participants. We analysed data from survey free-text responses and in-depth interviews using thematic analysis. Quantitative survey data is published elsewhere.

Setting

The UK.

Participants

Women were eligible if living in the UK, aged 16–45 years, were pregnant or had been pregnant in the last 5 years regardless of pregnancy outcome. A total of 7090 women completed the survey, and 34 women who collectively had experienced 68 pregnancies were subsequently interviewed.

Results

Medication prescribing and use during pregnancy was common. The prescribing, dispensing and taking of some advised medications were restricted through women’s or prescribers’ fear of fetal harm. Lack of adherence to national prescribing guidance, conflicting professional opinion and poor communication resulted in maternal anxiety, avoidable morbidity and women negotiating complex and distressing pathways to obtain recommended medications. In contrast, some women felt overmedicated and that pharmacological treatments were used without exploring other options first.

Conclusion

Increased translation of national guidance into practice and greater personalisation of antenatal care are needed to improve the safety, efficacy and personalisation of prescribing in pregnancy.
Registry randomised trials: a methodological perspective
Authors: Doherty Dorota A , Tong Steven Y C , Reilly Jennifer , Shrapnel Jane , McDonald Stephen , Ahern Susannah , Harris Ian , Tam Charmaine S , Brennan Angela L , Hodgson Carol , Wilcox Leonie , Balagurunathan Anitha , Butcher Belinda E , Reid Christopher M
Published: March 2023

Registry randomised clinical trials (RRCTs) have the potential to provide pragmatic answers to important clinical questions. RRCTs can be embedded into large population-based registries or smaller single site registries to provide timely answers at a reduced cost compared with traditional randomised controlled trials. RRCTs can take a number of forms in addition to the traditional individual-level randomised trial, including parallel group trials, platform or adaptive trials, cluster randomised trials and cluster randomised stepped-wedge trials. From an implementation perspective, initially it is advantageous to embed RRCT into well-established registries as these have typically already overcome any issues with end point validation and adjudication. With advances in data linkage and data quality, RRCTs can play an important role in answering clinical questions in a pragmatic, cost-effective way.
Designing a library of lived experience for mental health (LoLEM): protocol for integrating a realist synthesis and experience based codesign approach
Authors: Lobban Fiona , Marshall Paul , Barbrook John , Collins Grace , Foster Sheena , Glossop Zoe , Inkster Clare , Jebb Paul , Johnston Rose , Khan Hameed , Lodge Christopher , Machin Karen , Michalak Erin , Powell Sarah , Rycroft-Malone Jo , Slade Mike , Whittaker Lesley , Jones Steven H
Published: March 2023

Introduction

People with lived expertise in managing mental health challenges can be an important source of knowledge and support for other people facing similar challenges, and for carers to learn how best to help. However, opportunities for sharing lived expertise are limited. Living libraries support people with lived expertise to be ‘living books’, sharing their experiences in dialogue with ‘readers’ who can ask questions. Living libraries have been piloted worldwide in health-related contexts but without a clear model of how they work or rigorous evaluation of their impacts. We aim to develop a programme theory about how a living library could be used to improve mental health outcomes, using this theory to codesign an implementation guide that can be evaluated across different contexts.

Methods and analysis

We will use a novel integration of realist synthesis and experience-based codesign (EBCD) to produce a programme theory about how living libraries work and a theory and experience informed guide to establishing a library of lived experience for mental health (LoLEM). Two workstreams will run concurrently: (1) a realist synthesis of literature on living libraries, combined with stakeholder interviews, will produce several programme theories; theories will be developed collaboratively with an expert advisory group of stakeholders who have hosted or taken part in a living library and will form our initial analysis framework; a systematic search will identify literature about living libraries; data will be coded into our analysis framework, and we will use retroductive reasoning to explain living libraries’ impacts across multiple contexts. Individual stakeholder interviews will help refine and test theories; (2) data from workstream 1 will inform 10 EBCD workshops with people with experience of managing mental health difficulties and health professionals to produce a LoLEM implementation guide; data from this process will also inform the theory in workstream 1.

Ethics and dissemination

Ethical approval was granted by Coventry and Warwick National Health Service Research Ethics Committee on 29 December 2021 (reference number 305975). The programme theory and implementation guide will be published as open access and shared widely through a knowledge exchange event, a study website, mental health provider and peer support networks, peer reviewed journals and a funders report.

PROSPERO registration details

CRD42022312789.
Understanding the healthcare providers’ perspective for bringing the assessment of burden of chronic conditions tool to practice: a protocol for an implementation study
Authors: Claessens Danny , Vervloet Marcia , Boudewijns Esther Adriana , Keijsers Lotte C E M , Gidding-Slok Annerika H M , van Schayck Onno C P , van Dijk Liset
Published: March 2023

Introduction

The Assessment of Burden of Chronic Conditions (ABCC) tool is developed and validated to support and facilitate a personalised approach to care for people with chronic conditions. The benefit of using the ABCC-tool greatly depends on how it is implemented. To enable a deeper understanding of when, how and by whom the ABCC-tool is used, this study protocol describes the design of an implementation study in which the context, experiences and implementation process of the ABCC-tool by primary care healthcare providers (HCPs) in the Netherlands will be investigated.

Methods and analysis

This protocol describes an implementation study alongside an effectiveness trial, in which the ABCC-tool is evaluated in general practices. The implementation strategy of the tool in the trial confines to providing written information and an instruction video explaining the technical use of the ABCC-tool. The outcomes include a description of: (1) the barriers and facilitators of HCPs for implementation of the ABCC-tool, guided by the Consolidated Framework for Implementation Research (CFIR) and (2) the implementation outcomes guided by the Reach-Effect-Adoption-Implementation-Maintenance (RE-AIM) framework Carroll’s fidelity framework. All outcomes will be gathered through individual semistructured interviews throughout 12 months of use. Interviews will be audiorecorded and transcribed. Transcripts will be analysed using content analysis for identifying barriers and facilitators (based on CFIR) and thematic analyses of HCPs’ experiences (based on the RE-AIM and the fidelity frameworks).

Ethics and dissemination

The presented study was approved by the Medical Ethics Committee of Zuyderland Hospital, Heerlen (METCZ20180131). Written informed consent is mandatory prior to participation in the study. The results from the study in this protocol will be disseminated through publication in peer-reviewed scientific journals and conference presentations.
Effects of non-invasive brain stimulation (NIBS) for executive function on subjects with ADHD: a protocol for a systematic review and meta-analysis
Authors: Peng Lihong , Tian Liyan , Wang Tiantian , Wang Qiu , Li Na , Zhou Hui
Published: March 2023

Introduction

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder with a high risk of multiple mental health and social difficulties. Executive function domains are associated with distinct ADHD symptom burdens. Non-invasive brain stimulation (NIBS) mainly includes repetitive transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), which is a promising technique, but its impact on the executive function of ADHD is uncertain. Therefore, the aim of this systematic review and meta-analysis is to derive solid and updated estimates on the effect of NIBS on executive function in children/adults with ADHD.

Methods and analysis

A systematic search will be performed through EMBASE, MEDLINE, PsycINFO and Web of Science databases from inception until 22 August 2022. Handsearching of grey literature and the reference lists of selected articles will also be conducted. Empirical studies assessing the effect of NIBS (TMS or tDCS) on executive function in children or adults with ADHD will be included. Two investigators will independently perform literature identification, data extraction and risk of bias assessment. Relevant data will be pooled by a fixed-effects or random-effects model according to I2statistic. Sensitivity analysis will be performed to test the robustness of the pooled estimates. Subgroup analyses will be conducted to investigate the potential heterogeneity. This protocol will generate a systematic review and meta-analysis that comprehensively synthesises the evidence on the NIBS treatment of executive function deficit of ADHD.

Ethics approval is not required as this is a protocol for a systematic review of published literature. The results will be submitted to a peer-reviewed journal or a conference.

PROSPERO registration number

CRD42022356476.
Lipid management in ischaemic stroke or transient ischaemic attack in China: result from China National Stroke Registry III
Authors: Xu Yu-Yuan , Chen Wei-Qi , Wang Meng-Xing , Pan Yue-Song , Li Zi-Xiao , Liu Li-Ping , Zhao Xing-Quan , Wang Yi-Long , Li Hao , Wang Yong-Jun , Meng Xia
Published: March 2023

Objectives

The aims of the study were to assess the management of low-density lipoprotein cholesterol (LDL-C) and the goal achievement, as well as to investigate the association between baseline LDL-C level, lipid-lowering treatment (LLT), and stroke recurrence in patients with ischaemic stroke or transient ischaemic attack (TIA).

Design

Our study was a post hoc analysis of the Third China National Stroke Registry (CNSR-III).

Setting

We derived data from the CNSR-III - a nationwide clinical registry of ischaemic stroke and TIA based on 201 participating hospitals in mainland China.

Participants

15,166 patients were included in this study with demographic characteristics, etiology, imaging, and biological markers from August 2015 to March 2018.

Primary and secondary outcome measures

The primary outcome was a new stroke, LDL-C goal (LDL-C<1.8mmol/L and LDL-C<1.4mmol/L, respectively) achievement rates, and LLT compliance within 3, 6, and 12 months. The secondary outcomes included major adverse cardiovascular events (MACE) and all caused death at 3 and 12 months.

Results

Among the 15,166 patients, over 90% of patients received LLT during hospitalization and 2 weeks after discharge; the LLT compliance was 84.5% at 3 months, 75.6% at 6 months, and 64.8% at 12 months. At 12 months, LDL-C goal achievement rate for 1.8mmol/L and 1.4mmol/L was 35.4% and 17.6%, respectively. LLT at discharge was associated with reduced risk of ischemic stroke recurrence (HR=0.69, 95% CI: 0.48-0.99, p=0.04) at 3 months. The rate of LDL-C reduction from baseline to 3-month follow-up was not associated with a reduced risk of stroke recurrence or major adverse cardiovascular events (MACE) at 12 months. Patients with baseline LDL-C ≤1.4mmol/L had a numerically lower risk of stroke, ischemic stroke and MACE at both 3 months and 12 months.

Conclusions

The LDL-C goal achievement rate has increased mildly in the stroke and TIA population in mainland China. Lowered baseline LDL-C level was significantly associated with a decreased short- and long-term risk of ischemic stroke among stroke and TIA patients. LDL-C<1.4mmol/L might be a safe standard for this population.
What is the NCD service capacity and disruptions due to COVID-19? Results from the WHO non-communicable disease country capacity survey in the Americas region
Authors: Luciani Silvana , Caixeta Roberta , Chavez Carolina , Ondarsuhu Dolores , Hennis Anselm
Published: March 2023

Objective

This article presents the Americas regional results of the WHO non-communicable diseases (NCDs) Country Capacity Survey from 2019 to 2021, on NCD service capacity and disruptions from the COVID-19 pandemic.

Setting

Information on public sector primary care services for NCDs, and related technical inputs from 35 countries in the Americas region are provided.

Participants

All Ministry of Health officials managing a national NCD programme, from a WHO Member State in the Americas region, were included throughout this study. Government health officials from countries that are not WHO Member States were excluded.

Outcome measures

The availability of evidence-based NCD guidelines, essential NCD medicines and basic technologies in primary care, cardiovascular disease risk stratification, cancer screening and palliative care services were measured in 2019, 2020 and 2021. NCD service interruptions, reassignments of NCD staff during the COVID-19 pandemic and mitigation strategies to reduce disruptions for NCD services were measured in 2020 and 2021.

Results

More than 50% of countries reported a lack of comprehensive package of NCD guidelines, essential medicines and related service inputs. Extensive disruptions in NCD services resulted from the pandemic, with only 12/35 countries (34%), reporting that outpatient NCD services were functioning normally. Ministry of Health staff were largely redirected to work on the COVID-19 response, either full time or partially, reducing the human resources available for NCD services. Six of 24 countries (25%) reported stock out of essential NCD medicines and/or diagnostics at health facilities which affected service continuity. Mitigation strategies to ensure continuity of care for people with NCDs were deployed in many countries and included triaging patients, telemedicine and teleconsultations, and electronic prescriptions and other novel prescribing practices.

Conclusions

The findings from this regional survey suggest significant and sustained disruptions, affecting all countries regardless of the country’s level of investments in healthcare or NCD burden.
Prospective observational study on the accuracy of predictors of high-grade atrioventricular conduction block after transcatheter aortic valve implantation (CONDUCT-TAVI): study protocol, background and significance
Authors: Rao Karan , Bhatia Kunwardeep , Chan Bernard , Cowan Mitchell , Saad Natasha , Baer Alexandra , Sritharan Hari , Bromhead Ingrid , Whalley David , Allahwala Usaid K , Hansen Peter , Bhindi Ravinay
Published: March 2023

Introduction

Aortic stenosis is the most common cardiac valve pathology worldwide and has a mortality rate of over 50% at 5 years if left untreated. Transcatheter aortic valve implantation (TAVI) is a minimally invasive and highly effective alternative treatment option to open-heart surgery. High-grade atrioventricular conduction block (HGAVB) is one of the most common complications after TAVI and requires a permanent pacemaker. Due to this, patients are typically monitored for 48 hours post TAVI, however up to 40% of HGAVB may delayed, and occur after discharge. Delayed HGAVB can cause syncope or sudden unexplained cardiac death in a vulnerable population, and no accurate methods currently exist to identify patients at risk.

Methods and analysis

The prospective observational study on the accuracy of predictors of high-grade atrioventricular conduction block after transcatheter aortic valve implantation (CONDUCT-TAVI) trial is an Australian-led, multicentre, prospective observational study, aiming to improve the prediction of HGAVB, after TAVI. The primary objective of the trial is to assess whether published and novel invasive electrophysiology predictors performed immediately before and after TAVI can help predict HGAVB after TAVI. The secondary objective aims to further evaluate the accuracy of previously published predictors of HGAVB after TAVI, including CT measurements, 12-lead ECG, valve characteristics, percentage oversizing and implantation depth. Follow-up will be for 2 years, and detailed continuous heart rhythm monitoring will be obtained by inserting an implantable loop recorder in all participants.

Ethics and dissemination

Ethics approval has been obtained for the two participating centres. Results of the study will be submitted for publication in a peer-reviewed journal.

Trial registration number

ACTRN12621001700820.
Examining the acceptability of actigraphic devices in children using qualitative and quantitative approaches: protocol for a systematic review and meta-analysis
Authors: Morris Anna Charlotte , Telesia Laurence , Wickersham Alice , Epstein Sophie , Matcham Faith , Sonuga-Barke Edmund , Downs Johnny
Published: March 2023

Introduction

Actigraphy is commonly used to record free living physical activity in both typically and atypically developing children. While the accuracy and reliability of actigraphy have been explored extensively, research regarding young people’s opinion towards these devices is scarce. This review aims to identify and synthesise evidence relating to the acceptability of actigraphic devices in 5–11 year olds.

Methods and analysis

Database searches will be applied to Embase, MEDLINE, PsychInfo and Social Policy and Practice through the OVID interface; and Education Resources Information Center (ERIC), British Education Index and CINAHL through the EBSCO interface from January 2018 until February 2023. Supplementary forward and backward citation and grey literature database searches, including Healthcare Management Information Consortium (HMIC) and PsycEXTRA will be conducted. Qualitative and quantitative studies, excluding review articles and meta-analyses, will be eligible, without date restrictions. Article screening and data extraction will be undertaken by two review authors and disagreements will be deferred to a third reviewer. The primary outcome, actigraphic acceptability, will derive from the narrative synthesis of the main themes identified from included qualitative literature and pooled descriptive statistics relating to acceptability identified from quantitative literature. Subgroup analyses will determine if acceptability changes as a function of the key participant and actigraphic device factors.

Ethics and dissemination

Ethical approval is not required for this systematic review as it uses data from previously published literature. The results will be presented in a manuscript and published in a peer review journal and will be considered alongside a separate stream of codesign research to inform the development of a novel child-worn actigraphic device.

PROSPERO registration number

CRD42021232466.
Visual and ocular findings in children with fetal alcohol spectrum disorders (FASD): validating the FASD Eye Code in a clinical setting
Authors: Ayoub Lucyn , Aring Eva , Gyllencreutz Emelie , Landgren Valdemar , Svensson Leif , Landgren Magnus , Grönlund Marita Andersson
Published: March 2023

Objective

Fetal alcohol spectrum disorders (FASD) is an umbrella term covering a spectrum of medical conditions caused by prenatal alcohol exposure. The FASD Eye Code is a new complementary ophthalmological diagnostic tool created to corroborate the complex FASD diagnosis. The aim of this work was to validate the FASD Eye Code by testing it on a second group of children diagnosed with FASD in a clinical setting.

Methods and analysis

A clinical study was carried out in a group of 21 children (13 males, 8 females, mean age 13.3 years) investigated for suspected FASD and a healthy sex-matched and age-matched control group (n=21). The participants underwent a detailed ophthalmological examination including visual perception problems (VPPs) assessment. Clinical examination results were compiled, and total scores were calculated according to the FASD Eye Code protocol (range 4–16).

Results

The median total score in the FASD group was 8. Eight individuals in the FASD group and none of the controls obtained a total score of ≥9 corresponding to 38% sensitivity and 100% specificity with an area under the curve of 0.90. A cut-off total score of ≥8 showed 52% sensitivity and 95% specificity. One individual in the FASD group versus 12 controls had a total score of 4, representing normal findings. No significant difference between the two groups regarding VPPs was seen.

Conclusion

The FASD Eye Code can be used as a complementary diagnostic tool for FASD to assist in diagnosis and to detect ophthalmological abnormalities in individuals with suspected FASD.
A cross-sectional study of anxiety and depression caseness in female competitive figure skaters in Sweden
Authors: Jederström Moa , Agnafors Sara , Ekegren Christina L , Fagher Kristina , Gauffin Håkan , Korhonen Laura , Park Jennifer , Spreco Armin , Timpka Toomas
Published: March 2023

Objectives

Little is known about figure skaters’ mental health. This study aimed to describe anxiety and depression caseness (defined as a screening condition qualifying for psychiatric examination) in competitive figure skaters and analyse factors associated with such caseness.

Methods

A cross-sectional study was performed in April 2019 among all competitive figure skaters in the south-eastern region of Sweden (N=400). The primary outcomes were anxiety caseness, measured using the short-form Spielberger State-Trait Anxiety Inventory and depression caseness, measured using the WHO-5 index. Multivariable logistic regression models were employed to determine the association between anxiety caseness and explanatory factors.

Results

In total, 36% (n=142) of the invited skaters participated. Only females (n=137), mean age 12.9 (SD 3.0) years) were selected for analysis. Of the participating skaters, 47% displayed anxiety caseness and 10% depression caseness. Overweight body image perception (OR 5.9; 95% CI 2.0 to 17.6; p=0.001) and older age (OR 1.2; 95% CI 1.1 to 1.4; p=0.005) were associated with anxiety caseness. Skaters reporting no caseness were younger than those reporting only anxiety caseness (mean age difference −1.9 years; 95% CI −3.1 to −0.7; p=0.001) or anxiety and depression caseness (OR −3.5 years; 95% CI −5.6 to −1.5 years; p<0.001).

Conclusion

Anxiety caseness was associated with overweight body image perception and older age in female competitive figure skaters. Older skaters reported generally worse mental health. More research on the mental health of figure skaters is warranted, considering comorbidity and focusing on those needing further assessment and support.
Reproductive and sexual health of Australian adolescents exposed to family and domestic violence
Authors: Orr Carol , Kelty Erin , O'Donnell Melissa , Fisher Colleen M , Glauert Rebecca , Preen David B
Published: March 2023

Background

There is a dearth of research investigating sexually transmitted infections (STIs) in children exposed to family and domestic violence (FDV). Further, there is no research on terminations of pregnancy in children exposed to FDV.

Methods

This retrospective cohort study used linked administrative data from Western Australia to investigate whether exposure to FDV is associated with a risk of hospitalisations for STIs and terminations of pregnancy in adolescents. This study involved children born from 1987 to 2010 whose mother was a victim of FDV. Identification of family and domestic violence was from two sources: police and hospital records. This approach provided an exposed cohort of 16 356 and a non-exposed cohort of 41 996. Dependant variables were hospitalisations for pregnancy terminations and STIs in children aged from 13 up to 18 years of age. The primary explanatory variable was exposure to FDV. Multivariable Cox regression was used to investigate the association of FDV exposure and the outcomes.

Results

Following adjustment for sociodemographic and clinical factors, children exposed to FDV had an increased risk of hospitalisations for STIs (HR 1.49, 95% CI 1.15 to 1.92) and terminations of pregnancy (HR 1.34, 95% CI 1.09 to 1.63) as an adolescent than non-exposed peers.

Conclusion

Children exposed to FDV are at an increased risk of hospitalisation for STI and termination of pregnancy as an adolescent. Effective interventions are needed to support children exposed to FDV.
Guidance document: risk assessment of patients with cirrhosis prior to elective non-hepatic surgery
Authors: Abbas Nadir , Fallowfield Jonathan , Patch David , Stanley Adrian J , Mookerjee Raj , Tsochatzis Emmanouil , Leithead Joanna A , Hayes Peter , Chauhan Abhishek , Sharma Vikram , Rajoriya Neil , Bach Simon , Faulkner Thomas , Tripathi Dhiraj
Published: March 2023

As a result of the increasing incidence of cirrhosis in the UK, more patients with chronic liver disease are being considered for elective non-hepatic surgery. A historical reluctance to offer surgery to such patients stems from general perceptions of poor postoperative outcomes. While this is true for those with decompensated cirrhosis, selected patients with compensated early-stage cirrhosis can have good outcomes after careful risk assessment. Well-recognised risks include those of general anaesthesia, bleeding, infections, impaired wound healing, acute kidney injury and cardiovascular compromise. Intra-abdominal or cardiothoracic surgery are particularly high-risk interventions. Clinical assessment supplemented by blood tests, imaging, liver stiffness measurement, endoscopy and assessment of portal pressure (derived from the hepatic venous pressure gradient) can facilitate risk stratification. Traditional prognostic scoring systems including the Child-Turcotte-Pugh and Model for End-stage Liver Disease are helpful but may overestimate surgical risk. Specific prognostic scores like Mayo Risk Score, VOCAL-Penn and ADOPT-LC can add precision to risk assessment. Measures to mitigate risk include careful management of varices, nutritional optimisation and where possible addressing any ongoing aetiological drivers such as alcohol consumption. The role of portal decompression such as transjugular intrahepatic portosystemic shunting can be considered in selected high-risk patients, but further prospective study of this approach is required. It is of paramount importance that patients are discussed in a multidisciplinary forum, and that patients are carefully counselled about potential risks and benefits.
Risk of COVID-19 among unvaccinated and vaccinated patients with systemic lupus erythematosus: a general population study
Authors: Jiang Xiaofeng , Sparks Jeffrey , Wallace Zachary , Deng Xinjia , Li Hui , Lu Na , Xie Dongxing , Wang Yilun , Zeng Chao , Lei Guanghua , Wei Jie , Zhang Yuqing
Published: March 2023

Objective

To compare the risk of SARS-CoV-2 infection and its related severe sequelae between patients with systemic lupus erythematosus (SLE) and the general population according to COVID-19 vaccination status.

Methods

We performed cohort studies using data from The Health Improvement Network to compare the risks of SARS-CoV-2 infection and severe sequelae between patients with SLE and the general population. Individuals aged 18–90 years with no previously documented SARS-CoV-2 infection were included. We estimated the incidence rates and HRs of SARS-CoV-2 infection and severe sequelae between patients with SLE and the general population according to COVID-19 vaccination status using exposure score overlap weighted Cox proportional hazards model.

Results

We identified 3245 patients with SLE and 1 755 034 non-SLE individuals from the unvaccinated cohort. The rates of SARS-CoV-2 infection, COVID-19 hospitalisation, COVID-19 death and combined severe outcomes per 1000 person-months were 10.95, 3.21, 1.16 and 3.86 among patients with SLE, and 8.50, 1.77, 0.53 and 2.18 among general population, respectively. The corresponding adjusted HRs were 1.28 (95% CI: 1.03 to 1.59), 1.82 (95% CI: 1.21 to 2.74), 2.16 (95% CI: 1.00 to 4.79) and 1.78 (95% CI: 1.21 to 2.61). However, no statistically significant differences were observed between vaccinated patients with SLE and vaccinated general population over 9 months of follow-up.

Conclusion

While unvaccinated patients with SLE were at higher risk of SARS-CoV-2 infection and its severe sequelae than the general population, no such difference was observed among vaccinated population. The findings indicate that COVID-19 vaccination provides an adequate protection to most patients with SLE from COVID-19 breakthrough infection and its severe sequelae.
Nutrition and immunity: perspectives on key issues and next steps
Authors: Dunbar Carolyn L. , Aukema Harold M. , Calder Philip C. , Gibson Deanna L. , Henrickson Sarah E. , Khan Saad , Mailhot Geneviève , Panahi Shirin , Tabung Fred K. , Tom Mei , Upton Julia E.M. , Winer Daniel A. , Field Catherine J.
Published: March 2023

In January 2022, a group of experts came together to discuss current perspectives and future directions in nutritional immunology as part of a symposium organized by the Canadian Nutrition Society. Objectives included (1) creating an understanding of the complex interplay between diet and the immune system from infants through to older adults, (2) illustrating the role of micronutrients that are vital to the immune system, (3) learning about current research comparing the impact of various dietary patterns and novel approaches to reduce inflammation, autoimmune conditions, allergies, and infections, and (4) discussing select dietary recommendations aimed at improving disease-specific immune function. The aims of this review are to summarize the symposium and to identify key areas of research that require additional exploration to better understand the dynamic relationship between nutrition and immune function.
Do isotropic tidal forces imply isotropic cosmic expansion?
Authors: Dias Fabio Scalco , Gomes Leandro Gustavo , Mello Luis Fernando
Published: March 2023

We investigate the dynamics of the spatially flat universes submitted to isotropic tidal forces and adiabatic expansion under Einstein’s equations. Surprisingly, the tendency to a high Hubble anisotropy at late times starts to appear as far as we assume a strong-like energy condition to hold, a characteristic which becomes dominant in the radiation era and even more stringent under a stiff matter regime. This is a rather counter-intuitive behavior that shows us how, from the conceptual viewpoint, the Hubble parameter tends to anisotropize even when the universe is dominated by isotropic gravitational forces and usual physical conditions. We introduce the parameterb, which measures the relative variation in the magnitudes of the Hubble anisotropy against the scale factor, to show that mechanisms violating such an energy condition can compensate for this anisotropy increase. We also discuss if there is theoretical support for the existence of observational Hubble anisotropy in the late-time universe.
The hubble rate trouble: an effective field theory of dark matter
Authors: Jesus Alvaro S. de , Pinto-Neto Nelson , Queiroz Farinaldo S. , Silk Joseph , Silva Dêivid R. da
Published: March 2023

The Hubble constant inferred from the 6-parameter fit to the CMB power spectrum conflicts with the value obtained from direct measurements via type Ia supernova and Cepheids observations. We write down effective operators involving spin-0, spin-1/2, and spin-1 dark matter that lead to the relativistic production of dark matter particles at early times, and consequently lead to an increase in the number of relativistic degrees of freedom. This mechanism which is amenable to CMB, BBN, and structure formation observables can sufficiently raise the value of the Hubble constant derived from CMB and reconcile local and CMB probes of the Hubble constant. This mechanism alone increases $$H_0$$

H
0

up to $$70\, \textrm{km}\, \textrm{s}^{-1} \, \textrm{Mpc}^{-1}$$

70

km

s

-
1

Mpc

-
1

, and with the help of a Phantom-like cosmology, reach $$H_0 \simeq $$

H
0

≃

71–73 $$\textrm{km} \,\textrm{s}^{-1} \textrm{Mpc}^{-1}$$

km

s

-
1

Mpc

-
1

. Lastly, we outline the region of parameter space which reproduces $$H_0 \simeq $$

H
0

≃

71–73 $$\textrm{km} \,\textrm{s}^{-1} \, \textrm{Mpc}^{-1}$$

km

s

-
1

Mpc

-
1

while obeying all relevant constraints.
Information theoretic inequalities as bounds in superconformal field theory
Authors: Zhou Yang
Published: March 2023

In this paper, an information theoretic approach to bounds in superconformal field theories is proposed. It is proved that the supersymmetric Rényi entropy [Formula: see text] is a monotonically decreasing function of [Formula: see text] and [Formula: see text] is a concave function of [Formula: see text]. Under the assumption that the thermal entropy associated with the “replica trick” time circle is bounded from below by the charge at [Formula: see text], it is further proved that both [Formula: see text] and [Formula: see text] monotonically increase as functions of [Formula: see text]. Because [Formula: see text] enjoys universal relations with the Weyl anomaly coefficients in even-dimensional superconformal field theories, one therefore obtains a set of bounds on these coefficients by imposing the inequalities of [Formula: see text]. Some of the bounds coincide with Hofman–Maldacena bounds and the others are new. We also check the inequalities for examples in odd-dimensions.
Global Bifurcation in a Modified Leslie–Gower Predator–Prey Model
Authors: Tian Jialu , Liu Ping
Published: March 2023

This paper is concerned with the spatiotemporal heterogeneity in a modified Leslie–Gower predator–prey system with Beddington–DeAngelis functional response and prey-taxis. Using Crandall–Rabinowitz bifurcation theory, we investigate the steady-state bifurcation of the nonlinear system by choosing the prey-tactic sensitivity coefficient as a bifurcating parameter. It is rigorously proved that a branch of nonconstant solution exists near the positive equilibrium when the prey-tactic sensitivity is repulsive. Moreover, we study the existence, direction and stability of periodic orbits around the interior constant equilibrium by selecting the intrinsic growth rate of the prey as a bifurcating parameter. A priori estimates play a critical role in the verification procedure. Some numerical simulations are carried out to support our main theoretical results.
Steady-State Bifurcation in Previte–Hoffman Model
Authors: Chen Mengxin , Wu Ranchao
Published: March 2023

Prey-taxis, which describe the directed movement of the predator species, is introduced into the Previte–Hoffman model. Steady-state bifurcation is investigated in such model with the no-flux boundary conditions and the prey-taxis. Firstly, we present the stability analysis of the unique positive equilibrium, the existence of the Hopf bifurcation, and the steady-state bifurcation, respectively. Thereafter, to determine the existence and the stability of the nonconstant steady-state, which bifurcates from the steady-state bifurcation, the Crandall–Rabinowitz local bifurcation theory is employed to complete the tasks. As a result, the stability and instability of the nonconstant steady-state could be characterized. The results show that only the repulsive prey-taxis can induce the steady-state bifurcation of the Previte–Hoffman model. The bifurcations will lead to the occurrence of spatiotemporal patterns, which are demonstrated through numerical simulations.
Designing an Image Encryption Algorithm Based on Hyperchaotic System and DCT
Authors: Xu Jiangjian , Zhao Bing
Published: March 2023

In the field of secure communications, the robustness of cipher images transmitted in various channels is becoming increasingly important. In this paper, a robust image encryption algorithm combining a new chaotic system and discrete cosine transform is proposed, which is interlinked with plain information and is resistant to high-intensity noise attacks. First, a 5D continuous hyperchaotic system is proposed, leading to an interrelated sequence of five chaotic sequences. Second, the plain image is subjected to discrete cosine transform. Then the transform domain image is quantized, and some high-frequency components are removed, and then the high-frequency components are filled with chaotic sequences. Next, the transform domain image is scrambled, and inverse discrete cosine transform is performed, and its gray value is mapped to obtain a spatial domain image. Finally, the spatial image is scrambled by the spiral transformation, and then the diffusion operation is performed to obtain the encrypted image. Through the simulation experiment, the histogram, correlation, differential attack, and robustness are analyzed. The experimental results show that the proposed encryption algorithm can resist high-intensity noise attacks and has good encryption performance.
Learning Reactive Islands of the Voter97 System
Authors: Hind Alexander , Wiggins Stephen
Published: March 2023

In this paper, we assess the effectiveness of a widely used machine learning technique, support vector machines (SVM) for computing reactive islands in a benchmark system for testing molecular dynamics algorithms, the Voter97 model. Reactive islands are the phase space geometrical structure that mediate chemical reactions dynamics. The Voter97 model contains particular challenges for reaction dynamics methods as the reactant and product potential wells are separated by an intermediate well. We show that SVM can accurately compute the reactive islands in the Voter97 model and we assess the accuracy and the computational effort of the approach by comparing it with brute force methods for computing the reactive islands.
Peptide-Based Vectors: A Biomolecular Engineering Strategy for Gene Delivery
Authors: Urandur Sandeep , Sullivan Millicent O.
Published: March 2023

From the first clinical trial by Dr. W.F. Anderson to the most recent US Food and Drug Administration–approved Luxturna (Spark Therapeutics, 2017) and Zolgensma (Novartis, 2019), gene therapy has revamped thinking and practice around cancer treatment and improved survival rates for adult and pediatric patients with genetic diseases. A major challenge to advancing gene therapies for a broader array of applications lies in safely delivering nucleic acids to their intended sites of action. Peptides offer unique potential to improve nucleic acid delivery based on their versatile and tunable interactions with biomolecules and cells. Cell-penetrating peptides and intracellular targeting peptides have received particular focus due to their promise for improving the delivery of gene therapies into cells. We highlight key examples of peptide-assisted, targeted gene delivery to cancer-specific signatures involved in tumor growth and subcellular organelle–targeting peptides, as well as emerging strategies to enhance peptide stability and bioavailability that will support long-term implementation.
Things Fall Apart: Fixed Income Markets in the COVID-19 Crisis
Authors: O'Hara Maureen , Zhou Xing (Alex)
Published: March 2023

This article provides a critical appraisal of the March 2020 crisis in fixed income markets. We synthesize the main events, characterize what appears to be an emerging consensus on what caused the market breakdowns, summarize how the Federal Reserve's actions contributed to its resolution, and discuss potential lasting effects of the crisis. This review makes clearer the fragilities and interconnectedness that characterize the current fixed income market structure and their effects on liquidity provision. We argue that the current market structure, combined with the continued growth of Treasury markets, corporate and municipal bond markets, and particularly, mutual funds, raises the specter that periodic instability may remain a feature of fixed income markets.
From Embedded Autonomy to Counter-Hegemonic Globalization: A 60-Year Adventure in Exploring Comparative Political Economy
Authors: Evans Peter B.
Published: March 2023

I got hooked on sociology as a 20-year-old. Engaging with the world as a sociologist, together with colleagues, comrades, and students, has been immensely rewarding for six decades. My work has centered primarily on what were once called developing countries and now comprise the Global South. This article recounts my sociological adventures, from efforts to understand the world as I found it in the early 1960s to my responses to current reactionary trends. I start with my earlier work— Dependent Development (1979) and Embedded Autonomy (1995)—and then move to more recent efforts to construct paradigms of progressive twenty-first-century possibilities. I discuss, first, how a 21st century developmental state might incorporate deliberation and state-society synergies to expand human capabilities, and second, how an amalgam of global and national labor movements together with transnational advocacy networks might pursue a counter-hegemonic globalization capable of confronting global neoliberal capitalism.
Noble-Metal-Free Zinc Oxide Nanoparticle Electrodes for Electrochemical Detection of Benzene-Derived Compounds: 2,4,6-trinitrotoluene, 2,4-dinitrotoluene, and diphenylamine
Authors: Moon Sanghyeon , Yoo JeongEun , Lee Wonjoo , Lee Kiyoung
Published: March 2023

Zinc oxide nanoparticle electrode catalysts were used to electrochemically examine benzene-derived compounds by controlling geometric factors (particle size and oxide-layer thickness) to measure the detection sensitivity difference. Spin-coating was performed to control the nanoparticle layer thickness. First, a representative benzene-derived compounds (2,4,6-trinitrotoluene) was detected using cyclic voltammetry. Three main cathodic reduction peaks were confirmed in the range of −0.5 to −0.9 V (vs Ag/AgCl in 3 M KCl). 50 nm diameter and ∼2 μm thickness of zinc oxide nanoparticles appeared the best detection performance, due to the surface uniformity, high surface area, and electric conductivity. Two additional benzene-derived compounds (2,4-dinitrotoluene and diphenylamine) were utilized to measure the detectability of the zinc oxide nanoparticle layers. Consequently, 2,4-dinitrotoluene and diphenylamine were detected using cyclic voltammetry. The mass transfer of these three benzene-derived compounds affected the diffusion- and surface-controlled processes. Finally, the limits of detection, quantitation, and sensitivity of the benzene-derived compounds were recorded using differential pulse voltammetry. The results indicated that adjusting the geometric factor is a competitive method for enhancing the detection sensitivity. Moreover, this work can be extended to detect diverse benzene-derived compounds such as diazonitrophenol, nitrocellulose, picric acid, and tetryl.
Minimum effort simulations of split-belt treadmill walking exploit asymmetry to reduce metabolic energy expenditure
Authors: Price Mark , Huber Meghan E. , Hoogkamer Wouter
Published: March 2023

Behavioral observations of split-belt treadmill adaptation have been inconclusive toward its underlying causes. To estimate gait patterns when driven exclusively by one of these possible underlying causes, we simulated split-belt treadmill walking with a musculoskeletal model that minimized its summed muscle excitations. Our model took significantly longer steps on the fast belt and reduced its metabolic rate below tied-belt walking, unlike experimental observations. This suggests that asymmetry is energetically optimal, but human adaptation involves additional factors.
Nutritional Enhancement of Bread Produced from Wheat, Banana, and Carrot Composite Flour
Authors: Ewunetu Masresha Gebeyehu , Atnafu Alemneh Yazie , Fikadu Wondemagegn
Published: March 2023

The physicochemical and sensory evaluation of the bread produced from the composite flours of wheat, carrot, and banana was determined. Five bread samples were produced from the proportion of wheat/carrot/banana composite flours in the ratio 90% : 5% : 5% (blending ratio one), 80% : 10% : 10% (blending ratio two), 70% : 15% : 15% (blending ratio three), and 60% : 20% : 20% (blending ratio four), and 100% wheat was the control sample. The proximate composition of moisture, ash, crude fat, crude fiber, and beta-carotene contents of the composite bread increased significantly. The values of moisture%, ash%, crude fiber%, crude fat%, and β-carotene μg/100 g ranged from 29.92 ± 0.01–33.23 ± 0.0158, 0.67 ± 0.03–1.66 ± 0.01, 1.99 ± 0.01–6.47 ± 0.01, 1.127 ± 0.01–3.2 ± 0.01, and 0.13 ± 0.01–73.51 ± 0.01, respectively. The values of crude protein%, carbohydrate%, and caloric value (kcal) ranged from 10.02 ± 0.01–8.01 ± 0.01 and carbohydrate ranged from 47.42 ± 0.03 − 56.27 ± 0.01, 47.42 ± 0.03 − 56.27 ± 0.01, and 275.30 ± 0.06–250.55 ± 0.07, respectively. The mean of sensory scores varied with the increased addition of carrot and banana flours to the wheat flour. There was no significant difference in the overall acceptability of the bread for all the samples, except the control. The mean of sensory scores, however, showed that consumers preferred the bread from blending ratio four (60% : 20% : 20%) but bread from the composite flours of substitution for both carrot and banana flours was well accepted. The general objective of this project is to enhance the nutritional value of bread by adding carrot and banana flour to wheat flour. The study has shown that bread of acceptable quality can be produced from composite flour of wheat, carrot, and banana, which would increase nutrition and prevent malnutrition.
Tumor Suppressor Role of INPP4B in Chemoresistant Retinoblastoma
Authors: Miroschnikov Natalia , Dräger Oliver , Van Meenen Dario , Metz Klaus , Budeus Bettina , Dünker Nicole , Busch Maike Anna
Published: March 2023

The chemotherapy of retinoblastoma (RB), a malignant ocular childhood disease, is often limited by the development of resistance against commonly used drugs. We identified inositol polyphosphate 4-phosphatase type II (INPP4B) as a differentially regulated gene in etoposide-resistant RB cell lines, potentially involved in the development of RB resistances. INPP4B is controversially discussed as a tumor suppressor and an oncogenic driver in various cancers, but its role in retinoblastoma in general and chemoresistant RB in particular is yet unknown. In the study presented, we investigated the expression of INPP4B in RB cell lines and patients and analyzed the effect of INPP4B overexpression on etoposide resistant RB cell growth in vitro and in vivo. INPP4B mRNA levels were significantly downregulated in RB cells lines compared to the healthy human retina, with even lower expression levels in etoposide-resistant compared to the sensitive cell lines. Besides, a significant increase in INPP4B expression was observed in chemotherapy-treated RB tumor patient samples compared to untreated tumors. INPP4B overexpression in etoposide-resistant RB cells resulted in a significant reduction in cell viability with reduced growth, proliferation, anchorage-independent growth, and in ovo tumor formation. Caspase-3/7-mediated apoptosis was concomitantly increased, suggesting a tumor suppressive role of INPP4B in chemoresistant RB cells. No changes in AKT signaling were discernible, but p-SGK3 levels increased following INPP4B overexpression, indicating a potential regulation of SGK3 signaling in etoposide-resistant RB cells. RNAseq analysis of INPP4B overexpressing, etoposide-resistant RB cell lines revealed differentially regulated genes involved in cancer progression, mirroring observed in vitro and in vivo effects of INPP4B overexpression and strengthening INPP4B’s importance for cell growth control and tumorigenicity.