bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of eHealth‐based cognitive behavioural therapy on depression: A systematic review and meta‐analysis
Authors: Chan Ming , Jiang Ying , Lee Cheuk Yiu Charlotte , Ramachandran Hadassah Joann , Teo Jun Yi Claire , Seah Chuen Wei Alvin , Lin Yanjun , Wang Wenru
Published: January 2022

Aims and objectives

To systematically appraise the effects of eHealth cognitive behavioural therapy on depression and anxiety severity, quality of life, adherence and attrition rates observed in adults with clinically diagnosed depression.

Background

eHealth‐based cognitive behavioural therapy is an increasingly popular intervention on depression, but current reviews investigating the effects of eHealth interventions on depression are not exclusive to the clinically depressed.

Design

A systematic review and meta‐analysis.

Methods

Following the PRISMA guidelines, a systematic search of randomised controlled trials related to eHealth cognitive behavioural therapy published from inception from six databases and three trial registries was undertaken.

Results

A total of 15 studies were included in this systematic review. The meta‐analysis revealed that, when compared to passive comparators, eHealth cognitive behavioural therapy had a statistically significant effect on depression (d = −0.62, 95% CI: −0.96 to −0.28, p = .0003) and anxiety severity (d = −0.65, 95% CI: −1.10 to −0.21, p = .004) but not for quality of life (d = 0.30, 95% CI: −0.09 to 0.07, p = .13). When compared to active comparators, a statistically significant effect on depression (d = −0.31, 95% CI: −0.55 to −0.07, p = .01) and anxiety severity (d = −0.50, 95% CI: −0.81 to −0.19, p = .002) was observed, but not for quality of life (d = 0.22, 95% CI: −0.04 to 0.48, p = .10). Weighted averages for adherence and attrition rates were low.

Conclusion

eHealth cognitive behavioural therapy showed effectiveness in reducing depression and anxiety severity, but not quality of life. Further research is required to culturally adapt CBT interventions and explore the long‐term benefits of eHealth cognitive behavioural therapy.

Relevance to clinical practice

The use of eHealth‐based cognitive behavioural therapy could potentially bridge treatment gaps and serve as an adjunct to active treatment plans or an alternative for those without access to treatment.
Systematics of Mukdenia and Oresitrophe (Saxifragaceae): Insights from genome skimming data
Authors: Liu Lu‐Xian , Deng Pan , Chen Meng‐Zhen , Yu Li‐Min , Lee Joongku , Jiang Wei‐Mei , Fu Cheng‐Xin , Shang Fu‐De , Li Pan
Published: January 2022

Oresitrophe and Mukdenia (Saxifragaceae) are epilithic sister genera used in traditional Chinese medicine. The taxonomy of Mukdenia, especially of M. acanthifolia, has been controversial. To address this, we produced plastid and mitochondrial data using genome skimming for Mukdenia acanthifolia and Mukdenia rossii, including three individuals of each species. We assembled complete plastomes, mitochondrial CDS and nuclear ribosomal ETS/ITS sequences using these data. Comparative analysis shows that the plastomes of Mukdenia and Oresitrophe are relatively conservative in terms of genome size, structure, gene content, RNA editing sites and codon usage. Five plastid regions that represent hotspots of change (trnH‐psbA, psbC‐trnS, trnM‐atpE, petA‐psbJ and ccsA‐ndhD) are identified within Mukdenia, and six regions (trnH‐psbA, petN‐psbM, trnM‐atpE, rps16‐trnQ, ycf1 and ndhF) contain a higher number of species‐specific parsimony‐informative sites that may serve as potential DNA barcodes for species identification. To infer phylogenetic relationships between Mukdenia and Oresitrophe, we combined our data with published data based on three different datasets. The monophyly of each species (Oresitrophe rupifraga, M. acanthifolia and M. rossii) and the inferred topology ((M. rossii, M. acanthifolia), O. rupifraga) are well supported in trees reconstructed using the complete plastome sequences, but M. acanthifolia and M. rossii did not form a separate clade in the trees based on ETS + ITS data, while the mitochondrial CDS trees are not well‐resolved. We found low recovery of genes in the Angiosperms353 target enrichment panel from our unenriched genome skimming data. Hybridization or incomplete lineage sorting may be the cause of discordance between trees reconstructed from organellar and nuclear data. Considering its morphological distinctiveness and our molecular phylogenetic results, we strongly recommend that M. acanthifolia be treated as a distinct species.
The case for increased peritoneal dialysis utilization in low‐ and lower‐middle‐income countries
Authors: Okpechi Ikechi G. , Jha Vivekanand , Cho Yeoungjee , Ye Feng , Ijezie Chukwuonye I. , Jindal Kailash , Klarenbach Scott , Makusidi Muhammad A. , Okpechi‐Samuel Ugochi S. , Okwuonu Chimezie , Shah Nikhil , Thompson Stephanie , Tonelli Marcello , Johnson David W. , Bello Aminu K.
Published: January 2022

Peritoneal dialysis (PD) has several advantages compared to haemodialysis (HD), but there is evidence showing underutilization globally, especially in low‐income and lower‐middle‐income countries (LLMICs) where kidney replacement therapies (KRT) are often unavailable, inaccessible, and unaffordable. Only 11% of all dialysis patients worldwide use PD, more than 50% of whom live in China, the United States of America, Mexico, or Thailand. Various barriers to increased PD utilization have been reported worldwide including patient preference, low levels of education, and lower provider reimbursement. However, unique but surmountable barriers are applicable to LLMICs including the excessively high cost of providing PD (related to PD fluids in particular), excessive cost of treatment borne by patients (relative to HD), lack of adequate PD training opportunities for doctors and nurses, low workforce availability for kidney care, and challenges related to some PD outcomes (catheter‐related infections, hospitalizations, mortality, etc.). This review discusses some known barriers to PD use in LLMICs and leverages data that show a global trend in reducing rates of PD‐related infections, reducing rates of modality switches from HD, and improving patient survival in PD to discuss how PD use can be increased in LLMICs. We therefore, challenge the idea that low PD use in LLMICs is unavoidable due to these barriers and instead present opportunities to improve PD utilization in LLMICs.
Mathematical modeling to inform the development of national guidelines on infant feeding in Thailand
Authors: Chittchang Uraiporn , Rojroongwasiukul Nipa , Winnichagoon Pattanee , Watson Louise , Ferguson Elaine
Published: January 2022

The development of national dietary guidelines promoting healthy food choices is a public health priority in Thailand. In developing the recent national complementary feeding guidelines (CFGs) for 6‐ to 12‐month‐old children, mathematical modeling was used to inform decisions. Model parameters were derived from nationally representative dietary data and analyzed for 11 micronutrients by age group, using linear programming analysis in Optifood. Models were run to identify micronutrients whose nutrient reference values could not be met using local foods as consumed (problem nutrients), evaluate the original 2012 Thai CFGs, and predict the nutritional benefits of a specific fortified complementary food. The results identified three problem nutrients (iron, calcium, and zinc), which, for 9‐ to 11‐month‐olds, were reduced to one when the fortified food was modeled. The number of servings/week of vegetables and meat, fish or eggs were higher, and of oil and fruit were lower, in the modeled nutritionally best rather than observed diets (medians). When modeled, the original Thai CFGs were not feasible because the energy constraint was exceeded; hence, in revising them, the recommended number of servings/week of oil and fruit were reduced. This study demonstrates the advantages of using mathematical modeling, when revising national CFGs, to evaluate and improve them.
Molecular docking of brazilin and its analogs to barrier‐to‐autointegration factor 1 (BAF1)
Authors: Correia Soeiro Maria de Nazaré , Vergoten Gérard , Bailly Christian
Published: January 2022

The tetracyclic phenolic compound brazilin, derived from the wood of Caesalpinia sappan, has been shown to bind to the chromatin protein BAF1 (barrier‐to‐autointegration factor 1), a protein essential to maintain integrity of the nuclear envelope in cells. BAF1 plays a role in cancer development. Using molecular docking, we have located the binding site for brazilin on the surface of the BAF1 monomer and compared its binding to that of four analogs. The oxidized product brazilein (ΔE = −57.7 kcal/mol) exhibits a higher affinity for BAF1 compared to the reduced form brazilin (ΔE = −38.2 kcal/mol). Incorporation of a 4‐hydroxyl substituent on the indenochromene unit affords hematoxylin and hematein. In silico analysis predicts that the oxidized form hematein (ΔE = −66.2 kcal/mol) displays a higher affinity for BAF1 than the reduced form hematoxylin (ΔE = −42.2 kcal/mol). In contrast, the atypical bis‐lactone product brazilide A cannot form good complexes with BAF1. The analysis points to the formation of more stable BAF1 complexes with the oxidized molecules compared to the reduced ones, but the position of the binding site on the protein cavity is different for brazilin/hematoxylin compared to brazilein/hematein. Our study may be useful to guide the design of BAF1 ligands.
Integrated production and renewable energy generation in the presence of hydrogen energy storage
Authors: Feng Youyi , Menezes Mozart B.C.
Published: January 2022

In this paper, we propose an inventory model that considers dual sources with energy storage to address the energy efficiency of an effective make‐to‐stock production facility that has access to grid electricity and a source of renewable energy, along with energy‐storage capabilities. Such systems are being implemented in practice; however, the literature on inventory models does not offer solutions for extracting value from the management of such a complex energy mix coupled to energy‐storage technologies. We explore a periodic review production/inventory model in which hydrogen functions as an energy‐storage mechanism. We identify the structural properties of the objective function and obtain managerial insights through a complementarity analysis that is aimed at characterizing optimal energy‐efficiency policies.
Technical note: Sufficient operational statistics
Authors: Jia Justin , Katok Elena
Published: January 2022

The decision in a data‐driven decision‐making problem is generally a high‐dimensional function of data. When can the decision be reduced to a single‐dimensional function of a statistic? This study addresses this question based on the operational statistics literature. The study introduces the notion of sufficient operational statistics and derives the factorization theorem for identifying such statistics. Further, the study proposes a solution procedure based on the statistics and derives the finite‐sample performance bound of the proposed solution.
Hydrogen sulfide‐mediated mitigation and its integrated signaling crosstalk during salinity stress
Authors: Srivastava Vikas , Chowdhary Aksar Ali , Verma Praveen Kumar , Mehrotra Shakti , Mishra Sonal
Published: January 2022

Environmental stresses negatively affect plant development and significantly influence global agricultural productivity. The growth suppression due to soil salinity involves osmotic stress, which is accompanied by ion toxicity, nutritional imbalance, and oxidative stress. The amelioration of salinity stress is one of the fundamental goals to be achieved to ensure food security and better meet the issues related to global hunger. The application of exogenous chemicals is the imperative and efficient choice to alleviate stress in the agricultural field. Among them, hydrogen sulfide (H2S, a gasotransmitter) is known for its efficient role in stress mitigation, including salinity stress, along with other biological features related to growth and development in plants. H2S plays a role in improving photosynthesis and ROS homeostasis, and interacts with other signaling components in a cascade fashion. The current review gives a comprehensive view of the participation of H2S in salinity stress alleviation in plants. Further, its crosstalk with other stress ameliorating signaling component or supplement (e.g., NO, H2O2, melatonin) is also covered and discussed. Finally, we discuss the possible prospects to meet with success in agricultural fields.
An EEG study of the combined effects of top‐down and bottom‐up attentional selection under varying task difficulty
Authors: Rashal Einat , Senoussi Mehdi , Santandrea Elisa , Ben‐Hamed Suliann , Macaluso Emiliano , Chelazzi Leonardo , Boehler C. Nico
Published: January 2022

We examined the effect of combined top‐down and bottom‐up attentional control sources, using known attention‐related EEG components that are thought to reflect target selection (N2pc) and distractor suppression (PD). We used endogenous cues (valid vs. neutral) for top‐down attentional control, and salience in the form of color singletons (either the target or a distractor) for bottom‐up attentional control in visual search. Crucially, in two experiments, the task was of increasing difficulty, reporting the orientation of a tilted target (Experiment 1), or the position of a small gap within the target among tilted non‐targets (Experiment 2). Our results showed strong cueing effects on RT and accuracy in both experiments, demonstrating a general facilitation of responses to validly cued targets. Whereas the processing of salient targets was not improved compared with non‐salient targets, the presence of a salient distractor consistently worsened performance. The N2pc and PD were only observed in trials where targets were preceded by neutral cues in Experiment 1, and for validly cued targets and salient neutrally cued targets in Experiment 2. A cueing effect was found on the PD in Experiment 1, showing an amplitude reduction in trials where the target was validly cued. These results support the idea that bottom‐up attentional allocation occurs only when top‐down allocation of attention is absent or inefficient. Therefore, these results indicate that attentional selection and suppression during visual search are both influenced by top‐down cueing and give support to theories that focus on the interaction between the two types of attention.
The Role of Gender in Government and Nonprofit Workplaces: An Experimental Analysis of Rule Compliance and Supervisor Trust
Authors: Piatak Jaclyn , McDonald Jared , Mohr Zachary
Published: January 2022

The underrepresentation of women in leadership positions persists. Existing research examines barriers women face in climbing organizational hierarchies, but we know less about women who break past the glass ceiling. Once women obtain supervisory positions, do they face additional hurdles in managing employees? Specifically, how does gender, gender congruence, and rule formalization influence employee rule compliance and trust? Using a survey experiment across both government and nonprofit contexts, we find that both men and women are more likely to trust men managers, but this gender gap is mitigated when rules are written. Gender congruence plays a role for rule compliance, where both men and women are more compliant when the supervisor matches their gender, while gender congruence is only a significant factor for enhancing trust for men. The findings advance role incongruence theory and have implications for the challenges women leaders face in terms of trust and rule following.
The Impact of Demographic Composition of Social Networks on Perceived Inclusion in the Workplace
Authors: Jung Heyjie , Welch Eric W.
Published: January 2022

Inclusion in the workplace is defined as the extent to which individuals perceive that they are part of significant processes in organizations. This article explores the determinants of workplace inclusion by asking: How does the demographic composition of social networks inside and outside of the workplace affect perceived inclusion in the workplace? We apply literature on social identity theory and social network theory to develop and test hypotheses on professional sub‐network demographic composition using the linear regression analysis on data from the 2011 National Science Foundation–funded national survey of academic faculty on work environment and careers in US universities. Among other results, we find that perceived inclusion is explained by the interactions between race, gender, and demographic composition of professional networks. Findings provide new insights for the management of diversity in the workplace.
Who owns the pipes? Utility ownership, infrastructure conditions, and methane emissions in United States natural gas distribution
Authors: Scott Ryan P. , Scott Tyler A. , Greer Robert A.
Published: January 2022

Critical infrastructure systems that provide local public services are owned by a complicated array of public and private entities that are subject to disparate regulatory regimes. Determining whether and why performance differences between public and private service providers emerge in these different contexts is critical for understanding the efficacy of current management efforts and informing policy choices about how to deal with public and private service providers. This paper analyzes a census of all U.S. gas distributors and a more detailed sample of the largest utilities in the United States to model how sector and regional market concentration relate to infrastructure quality and leak volumes. Using safety reports, market data, and yearly infrastructure records submitted by gas distributors from 2010 to 2017, the article uses a series of Bayesian hierarchical models to show that publicly owned utilities report lower quality infrastructure (i.e., operation of pipelines with lower quality materials),but alsoself‐report significantly lower leak rates, all else equal. The article concludes by discussing potential explanations for this discrepancy, including the capital investment incentives private utilities face under cost‐of‐service pricing regulations and the fact that performance measurement capacity is itself a potential outgrowth of increased investment and expenditures.
The use of general anaesthesia in special care dentistry: A clinical guideline from the British Society for Disability and Oral Health
Authors: Geddis‐Regan Andrew R. , Gray Deborah , Buckingham Sarah , Misra Upma , Boyle Carole ,   the British Society for Disability and Oral Health
Published: January 2022

Background

General anaesthesia (GA) may be required to support the care of those seen in Special Care Dentistry (SCD) services for various reasons, such as enabling extensive dental care for people with severe learning disabilities or severe dental phobia. Guidance is needed for teams delivering SCD using GA due to the potential risks, implications, and costs of using GA to deliver dental care.

Aim

To present evidence‐based recommendations, where possible, for teams involved in providing GA for dental care for adults within SCD services.

Methods

A multidisciplinary working group, supported by a formal literature search and stakeholder involvement, iteratively produced and refined the recommendations presented.

Results

There was little evidence to inform the guidelines. Recommendations are therefore based mainly on the working group's expert consensus opinion. Clinical guidelines are presented as a set of overarching principles followed by six key sections reflecting patients' pathways from referral to dental services through to their care during and after GA.

Conclusion

Guidelines are presented to support those providing GA to provide SCD. The need for comprehensive and person‐centered assessment and planning is emphasized.
Immune gene activation by NPR and TGA transcriptional regulators in the model monocot Brachypodium distachyon
Authors: Shimizu Kohei , Suzuki Hitomi , Uemura Takuya , Nozawa Akira , Desaki Yoshitake , Hoshino Ryosuke , Yoshida Ayako , Abe Hiroshi , Nishiyama Makoto , Nishiyama Chiharu , Sawasaki Tatsuya , Arimura Gen‐ichiro
Published: January 2022

The nonexpressor of pathogenesis‐related (NPR) gene family is well known to play a crucial role in transactivation of TGA transcription factors for salicylic acid (SA)‐responsive genes, including pathogenesis‐related protein 1 (PR1), during plants' immune response after pathogen attack in the model dicot Arabidopsis thaliana. However, little is known about NPR gene functions in monocots. We therefore explored the functions of NPRs in SA signaling in the model monocot Brachypodium distachyon. BdNPR1 and BdNPR2/3 share structural similarities with A. thaliana AtNPR1/2 and AtNPR3/4 subfamilies, respectively. The transcript level of BdNPR2 but not BdNPR1/3 appeared to be positively regulated in leaves in response to methyl salicylate. Reporter assays in protoplasts showed that BdNPR2 positively regulated BdTGA1‐mediated activation of PR1. This transactivation occurred in an SA‐dependent manner through SA binding at Arg468 of BdNPR2. In contrast, BdNPR1 functioned as a suppressor of BdNPR2/BdTGA1‐mediated transcription of PR1. Collectively, our findings reveal that the TGA‐promoted transcription of SA‐inducible PR1 is orchestrated by the activator BdNPR2 and the repressor BdNPR1, which function competitively in B. distachyon.
One-Pot Pyrolysis to Nitrogen-Doped Hierarchically Porous Carbon Nanosheets as Sulfur-Host in Lithium–Sulfur Batteries
Authors: Zha Cheng , Liu Shuhe , Zhou Liexing , Li Kongzhai , Zhang Tianyu
Published: January 2022

Lithium–sulfur battery is a promising energy storage device because of its high theoretical specific energy density, low cost, and environmental friendliness. Here, we prepared nitrogen-doped hierarchically porous carbon nanosheets (N-PCNS) by NaCl salt-assisted one-pot pyrolysis strategy, using NaCl, glucose, and melamine as template, carbon and nitrogen as source. Using N-PCNS hosted sulfur composite material (N-PCNS/S) as the cathode material of the lithium–sulfur battery, the first specific discharge capacity at 0.2 C is 956.7 mA h g−1, and the reversible capacity after 100 cycles is 625.9 mA h g−1, with the capacity loss of 0.34% per cycle. At the high rate of 0.5 C, the specific capacity of the first discharge is still 717.3 mA h g−1. This study provides a simple and feasible strategy for the preparation of cathode materials for lithium–sulfur batteries.
Velocity reciprocity and the relativity principle
Authors: Moylan Patrick
Published: January 2022

Velocity reciprocity means that the velocity of an inertial frame S with respect to another inertial reference frame S′ is the opposite of the velocity of S′ with respect to S. While velocity reciprocity holds true for both the Lorentz and Galilean transformations, it need not be true in general, and it is a widely held misconception that velocity reciprocity is a sole consequence of the relativity of motion principle. The situation is, in fact, much more complicated, and it is the purpose of this paper to call attention to and hopefully help to rectify the matter regarding the misconception. We show that if we ascribe universal and unrestricted validity to the relativity of motion principle, then velocity reciprocity cannot possibly follow only from the relativity principle, and we detail the additional assumptions that must be made in order for velocity reciprocity to hold.
Interactions with stromal cells promote a more oxidized cancer cell redox state in pancreatic tumors
Authors: Datta Rupsa , Sivanand Sharanya , Lau Allison N. , Florek Logan V. , Barbeau Anna M. , Wyckoff Jeffrey , Skala Melissa C. , Vander Heiden Matthew G.
Published: January 2022

Access to electron acceptors supports oxidized biomass synthesis and can be limiting for cancer cell proliferation, but how cancer cells overcome this limitation in tumors is incompletely understood. Nontransformed cells in tumors can help cancer cells overcome metabolic limitations, particularly in pancreatic cancer, where pancreatic stellate cells (PSCs) promote cancer cell proliferation and tumor growth. However, whether PSCs affect the redox state of cancer cells is not known. By taking advantage of the endogenous fluorescence properties of reduced nicotinamide adenine dinucleotide and oxidized flavin adenine dinucleotide cofactors we use optical imaging to assess the redox state of pancreatic cancer cells and PSCs and find that direct interactions between PSCs and cancer cells promote a more oxidized state in cancer cells. This suggests that metabolic interaction between cancer cells and PSCs is a mechanism to overcome the redox limitations of cell proliferation in pancreatic cancer.
In vivo delivery of CRISPR-Cas9 using lipid nanoparticles enables antithrombin gene editing for sustainable hemophilia A and B therapy
Authors: Han Jeong Pil , Kim MinJeong , Choi Beom Seok , Lee Jeong Hyeon , Lee Geon Seong , Jeong Michaela , Lee Yeji , Kim Eun-Ah , Oh Hye-Kyung , Go Nanyeong , Lee Hyerim , Lee Kyu Jun , Kim Un Gi , Lee Jae Young , Kim Seokjoong , Chang Jun , Lee Hyukjin , Song Dong Woo , Yeom Su Cheong
Published: January 2022

Hemophilia is a hereditary disease that remains incurable. Although innovative treatments such as gene therapy or bispecific antibody therapy have been introduced, substantial unmet needs still exist with respect to achieving long-lasting therapeutic effects and treatment options for inhibitor patients. Antithrombin (AT), an endogenous negative regulator of thrombin generation, is a potent genome editing target for sustainable treatment of patients with hemophilia A and B. In this study, we developed and optimized lipid nanoparticles (LNPs) to deliver Cas9 mRNA along with single guide RNA that targeted AT in the mouse liver. The LNP-mediated CRISPR-Cas9 delivery resulted in the inhibition of AT that led to improvement in thrombin generation. Bleeding-associated phenotypes were recovered in both hemophilia A and B mice. No active off-targets, liver-induced toxicity, and substantial anti-Cas9 immune responses were detected, indicating that the LNP-mediated CRISPR-Cas9 delivery was a safe and efficient approach for hemophilia therapy.
First-passage statistics of colloids on fractals: Theory and experimental realization
Authors: Zunke Christoph , Bewerunge Jörg , Platten Florian , Egelhaaf Stefan U. , Godec Aljaž
Published: January 2022

In nature and technology, particle dynamics frequently occur in complex environments, for example in restricted geometries or crowded media. These dynamics have often been modeled invoking a fractal structure of the medium although the fractal structure was only indirectly inferred through the dynamics. Moreover, systematic studies have not yet been performed. Here, colloidal particles moving in a laser speckle pattern are used as a model system. In this case, the experimental observations can be reliably traced to the fractal structure of the underlying medium with an adjustable fractal dimension. First-passage time statistics reveal that the particles explore the speckle in a self-similar, fractal manner at least over four decades in time and on length scales up to 20 times the particle radius. The requirements for fractal diffusion to be applicable are laid out, and methods to extract the fractal dimension are established.
Giant synovial chondromatosis of hip
Authors: Pai Satvik N , Kumar Mohan M
Published: January 2022

Synovial chondromatosis is a rare, benign condition occurring due to metaplasia of synovium. A 65-year-old woman presented with pain in her right hip for 6 years. On examination, a swelling was palpable at the base of scarpa’s triangle and her right hip movements were restricted. Imaging modalities showed ossified nodules in the antero-inferior aspect of the hip joint, joint effusion and arthritic changes. We diagnosed the patient to have synovial chondromatosis with secondary arthritis of the hip joint. We performed a total hip arthroplasty with simultaneous synovectomy and extraction of the osteochondral loose bodies, 5 of which were about 2×2 cm in size. We found that excessive acetabular reaming was required due to craters, the osteochondral masses formed on the acetabular surface. Histopathological analysis confirmed the diagnosis. The patient had an excellent functional outcome and no recurrence 5 years following the surgery.
Internet-based platform for a low-calorie dietary intervention involving prepackaged food for weight loss in overweight and obese individuals in China: protocol for a randomised controlled trial
Authors: Wang Xi , Wang Suyuan , Zhang Chenghui , Zhong Lingyu , Lerman Lilach , Lerman Amir , Guo Yanhong , Wu Yunhong , Lopez-Jimenez Francisco
Published: January 2022

Introduction

Obesity is a global health issue that impacts quality of life. A calorie-restricted diet with high-intensity consultation provided via the internet may be an effective way to lose weight. The objective of this study was to assess the effectiveness of a practitioner-guided, mobile internet-based low-energy dietary intervention in overweight and obese populations in China.

Methods and analysis

This open-label randomised controlled trial enrolled 220 overweight and obese adults aged 18–70 years who met the inclusion criteria. Participants were assigned to the control group (n=110) or trial group (n=110). The trial group will be enrolled in the MetaWell programme, a weight loss programme using diet replacement products, wireless scales and a mobile phone app. Participants in the control group will receive paper material containing a sample diet for weight loss. The follow-up period will be 1 year, and measurements will occur at 3, 6 and 12 months. Dual-emission X-ray absorptiometry and abdominal quantitative CT will be performed to estimate the percentage of overall body fat and areas of visceral and subcutaneous fat, alongside several cardiometabolic measurements. The primary outcome of this study is the change in body mas index (BMI) at 6 months after enrolment. A mixed-effects model will be used to compare BMI and body fat changes between the two groups.

Ethics and dissemination

This study was approved by the ethics committee of the Hospital of Chengdu Office of the People’s Government of the Tibetan Autonomous Region. Advertisements for recruitment will be sent via official accounts using WeChat. The results will be disseminated via publications in academic journals and our clinic. Our study group will maintain contact with the participants to inform them of the study findings.

Trial registration number

ChiCTR1900021630.
Perspectives of mild asthma patients on maintenance versus as-needed preventer treatment regimens: a qualitative study
Authors: Foster Juliet , Beasley Richard , Braithwaite Irene , Harrison Tim , Holliday Mark , Pavord Ian , Reddel Helen
Published: January 2022

Objectives

As-needed low-dose combination budesonide-formoterol is recommended by asthma guidelines in many countries as an alternative to maintenance inhaled corticosteroids (ICS) for treatment of mild asthma, but there are few data on patient attitudes toward these regimens. This study explored the comparative implementation experiences and future treatment preferences of mild asthma patients who had experienced these two treatment regimens.

Setting

A subgroup of adults randomised to maintenance ICS or as-needed ICS-formoterol in a multinational, 52-week open-label randomised controlled trial (NovelSTART) in mild asthma patients were interviewed to explore their motivations for treatment use during the study and their preferences for future treatment.

Participants

Semistructured interviews were conducted with 74 participants (Maintenance group: n=39, As-needed group n=35, mean age 38 (range 19–69)) and thematically analysed from transcribed audiorecordings.

Results

Emergent themes from analysis comprised: ‘How much my asthma affects me’ (how their asthma’s impact affected their self-management motivation); ‘What I know about asthma’ (limited knowledge impeded appropriate self-management decision making); ‘How much effort this treatment regimen involves for me’ (treatment complexity and/or difficulty establishing a medication routine impeded implementation, particularly in the Maintenance group); and ‘My beliefs about the benefits and risks of this treatment’ (patients who considered their treatment as ineffective, eg, limited difference in symptoms relative to salbutamol (both groups) or slower onset of relief (As-needed group) had poor motivation to use the treatment). Due to the simplicity of the as-needed combination strategy, this was the preferred future regimen, even by patients who had not yet tried it.

Conclusions

Key patient perspectives on the implementation of preventer treatments for mild asthma included factors relating to perceived asthma burden, disease knowledge, treatment complexity and treatment usefulness or safety. The as-needed budesonide-formoterol regimen was preferred to maintenance ICS treatment in mild asthma though patient education is urgently needed to address implementation motivation.

Trial registration number

ACTRN12615000999538.
Individual readiness for transplantation medicine of laypersons and the number of deceased organ donors: a cross-sectional online survey in Japan, South Korea and Taiwan
Authors: Asai Tomoko , Taniguchi Yasuhiro , Tsukata Yukiyoshi
Published: January 2022

Objectives

The gap between the numbers of organ donors and recipients is a common problem worldwide. This study was designed to investigate the importance of ‘individual readiness’, a here introduced novel concept in transplantation medicine and a measure of positive attitudes towards organ donation and transplantation.

Design

A cross-sectional online survey was used to collect the research data.

Participants

The participants were recruited by a Japanese research company and affiliates in South Korea and Taiwan and fulfilled the following criteria: (1) laypersons aged 18–75 years, (2) residents of the countries and (3) understood the questions in their native languages.

Primary outcome measures

The survey investigated the interest and attitude of individuals regarding transplantation medicine by asking multiple choice questions. Based on answers concerning attitude, a positive group was identified as willing to be organ donors and recipients, and a non-positive group was identified as unwilling to be donors and recipients. The ratio between the positive and non-positive group, the P/N ratio, was introduced as an index of individual readiness.

Results

1500 samples were included in this analysis. Individuals with interest agreed more with statements on organ donation than those without interest, and the P/N ratio per country was compatible with the actual deceased organ donors rate per million population (ADODR).

Conclusions

Interest in transplantation medicine was associated with positive attitudes, and positive attitudes were associated with a higher ADODR. These results support that individual readiness is an important determinant for the number of donors. The P/N ratio can be used as an index to assess individual readiness in organ transplantation, at least in countries with minor to moderate popularisation. Further studies of individual readiness using the P/N ratio should be undertaken to develop policies and initiatives for increasing organ donations.
Effect of perioperative levosimendan administration on postoperative N-terminal pro-B-type natriuretic peptide concentration in patients with increased cardiovascular risk factors undergoing non-cardiac surgery: protocol for the double-blind, randomised, placebo-controlled IMPROVE trial
Authors: Reiterer Christian , Kabon Barbara , Taschner Alexander , Adamowitsch Nikolas , Graf Alexandra , Fraunschiel Melanie , Horvath Katharina , Kuhrn Melanie , Clement Theresa , Treskatsch Sascha , Berger Christian , Fleischmann Edith
Published: January 2022

Introduction

Elevated N-terminal pro-brain natriuretic peptide (NT-pro-BNP) after non-cardiac surgery is a strong predictor for cardiovascular complications and reflects increased myocardial strain. NT-pro-BNP concentrations significantly rise after non-cardiac surgery within the first 3 days. Levosimendan is a potent inotropic drug that increases calcium sensitivity to cardiac myocytes, which results in improved cardiac contractility that last for approximately 7 days. Thus, we will test the effect of a pre-emptive perioperative administration of levosimendan on postoperative NT-pro-BNP concentration as compared with the administration of a placebo in patients undergoing moderate-risk to high-risk major abdominal surgery.

Methods and analysis

We will conduct a double-blinded prospective randomised trial at the Medical University of Vienna, Vienna, Austria (and potentially a second centre in Germany), including 230 patients at-risk for cardiovascular complications undergoing moderate- to high-risk major abdominal surgery. Patients will be randomly assigned to receive a single dose of 12.5 mg levosimendan versus placebo after induction of anaesthesia. The primary outcome will be the postoperative maximum NT-pro-BNP concentration between both group within the first three postoperative days. Our secondary outcomes will be the incidence of myocardial ischaemia, myocardial injury after non-cardiac surgery and a composite of myocardial infarction and death within 30 days and 1 year after surgery between both groups. Our further secondary outcome will be stratification of NT-pro-BNP values according to previously thresholds to predict mortality of myocardial infarction after surgery.

Ethics and dissemination

The study was approved by the Ethics Committee of the Medical University of Vienna on 14 July 2020 (EK 2187/2019). Written informed consent will be obtained from all patients a day before surgery. Results of this study will be submitted for publication in a peer-reviewed journal.

Trial registration number

NCT04329624.
Barriers and enablers to monitoring and deprescribing opioid analgesics for chronic non-cancer pain: a systematic review with qualitative evidence synthesis using the Theoretical Domains Framework
Authors: Cross Amanda J , Buchbinder Rachelle , Mathieson Stephanie , Bourne Allison , Maher Christopher G , Lin Chung-Wei Christine , O'Connor Denise A
Published: January 2022

Background

Understanding barriers and enablers to monitoring and deprescribing opioids will enable the development of tailored interventions to improve both practices.

Objective

To perform a qualitative evidence synthesis of the barriers and enablers to monitoring ongoing appropriateness and deprescribing of opioids for chronic non-cancer pain (CNCP) and to map the findings to the Theoretical Domains Framework (TDF).

Methods

We included English-language qualitative studies that explored healthcare professional (HCP), patient, carer and the general public’s perceptions regarding monitoring and deprescribing opioids for CNCP. We searched MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Allied and Complementary Medicine Database (AMED) and PsycINFO from inception to August 2020. Two authors independently selected the studies, extracted the data, assessed the methodological quality using the Critical Appraisal Skills Programme, and assessed the confidence in the findings using GRADE CERQual (Grading of Recommendations Assessment, Development, and Evaluation Confidence in the Evidence from Reviews of Qualitative Research). We used an inductive approach to synthesis of qualitative data and mapped identified themes to TDF domains.

Results

From 6948 records identified we included 21 studies, involving 209 HCPs and 330 patients. No studies involved carers or the general public. Five barrier themes were identified: limited alternatives to opioids, management of pain is top priority, patient understanding, expectations and experiences, prescriber pressures, and reluctance to change. Four enabler themes were identified: negative effects of opioids and benefits of deprescribing, clear communication and expectations for deprescribing, support for patients, and support for prescribers. 16 barrier and 12 enabler subthemes were identified; most were graded as high (n=15) or moderate (n=9) confidence. The TDF domains ‘beliefs about consequences’, ‘environmental context and resources’, ‘social influences’ and ‘emotion’ were salient for patients and HCPs. The domains ‘skills’ and ‘beliefs about capabilities’ were more salient for HCPs.

Conclusion

Future implementation interventions aimed at monitoring and deprescribing opioids should target the patient and HCP barriers and enablers identified in this synthesis.

PROSPERO registration number

CRD42019140784.
Comparison of radiation exposure and clinical outcomes between transradial and transfemoral diagnostic cerebral approaches: a retrospective study
Authors: Amankwah Curtis , Lombardo Lauren , Rutledge John , Sattar Ahsan , Chancellor Bree , Altschul Dorothea
Published: January 2022

Objective

To identify and compare patient and procedural variables that are associated with a high radiation dose exposure and worse clinical outcomes between transradial arterial (TRA) and transfemoral arterial (TFA) approaches.

Design

This was a retrospective analysis.

Setting

A community hospital during the initial phase of adopting a TRA-first approach.

Participants

A resultant 215 subjects who only underwent diagnostic cerebral angiograms (DCA) after excluding all therapeutic procedures and patients under 18 years.

Interventions

Only DCA from 1 May 2018 to 31 January 2021.

Main outcome measures

We compared radiation exposure parameters (total fluoroscopy time (FT), total radiation dose (TD) and dose area product (DAP), number of vessels injected and Patient-Reported Global Health Physical and Mental Outcome Scores (PROGHS) at 30 days postprocedure between groups.

Results

FT was significantly greater in TRA compared with TFA (p<0.001). In addition, TRA had a significantly higher TD (p=0.002) and DAP (p=0.005) when compared with TFA. Analysis of only 6-vessel DCAs also showed that TRA had a significantly higher FT, DAP and TD in comparison to TFA. Despite observing a longer FT in TRA, results showed fewer vessels injected and a notably lower success rate in acquiring a 6-vessel DCA using the TRA. Further analysis of the effect of vessel number on FT using general linear models showed that with every increase of one vessel, the FT increases by 2.2 min for TRA (p<0.001; 95% CI 1.03 to 3.36) and by 1.3 min for TFA (p<0.001; 95% CI 0.72 to 1.83). There was no significant difference between groups in PROGHS mental and physical t-scores at 30 days postprocedure, even though our cohort showed a significantly greater percentage of TRA procedures done in the outpatient setting.

Conclusions

Adopting a TRA first approach for DCAs may be initially associated with a higher radiation dose for the patient. Better strategies and devices are needed to mitigate this effect.
Mass spectra, wave functions and mixing effects of the (bcq) baryons
Authors: Li Qiang , Chang Chao-Hsi , Qin Si-Xue , Wang Guo-Li
Published: January 2022

Mass spectra and wave functions of the $$J^P=\frac{1}{2}^+$$

J
P

=

1
2

+

(bcq) baryons are calculated by the relativistic Bethe–Salpeter equation (BSE) with considering the mixing effects between the $$1^+$$

1
+

and $$0^+$$

0
+

(bc)-diquarks inside. Based on the diquark picture, the three-body problem of baryons is transformed into two two-body problems. The BSE and wave functions of the $$0^+$$

0
+

diquark are given, and then solved numerically to obtain the effective mass spectra and form factors. Also we present the wave functions at zero point for the (bc)-diquark. Considering the obtained diquark form factors, the (bcq) baryons are then described by the BSE as the bound state of a diquark and a light quark, where the interaction kernel includes the inner transitions between the $$0^+$$

0
+

and $$1^+$$

1
+

diquarks. The general wave function of the $$\frac{1}{2}^+$$

1
2

+

(bcq) baryons is constructed and solved to obtain the corresponding mass spectra. Especially, by using the obtained wave functions, the mixing effects between $$\Xi _{bc}(\Omega _{bc})$$

Ξ

bc

(

Ω

bc

)

and $$\Xi _{bc}'(\Omega '_{bc})$$

Ξ

bc

′

(

Ω

bc

′

)

in ground states are computed and determined to be small ($$\sim \!1\%$$

∼

1
%

). The numerical results indicate that it is a good choice to take $$\Xi _{bc}$$

Ξ

bc

and $$\Xi '_{bc}$$

Ξ

bc

′

as the baryon states with the inside (bc)-diquarks occupying the definite spin.
Determining the State of Activity of Transcrustal Magmatic Systems and Their Volcanoes
Authors: Giordano G. , Caricchi L.
Published: January 2022

Polygenetic volcanoes and calderas produce eruptions of a wide variety of magnitudes, chemistries, and recurrence times. Understanding the interplay between long- and short-term and deep and shallow processes associated with accumulation and transfer of eruptible magma is essential for assessing the potential for future eruptions to occur and estimating their magnitude, which remains one of the foremost challenges in the Earth sciences. We review literature and use existing data for emblematic volcanic systems to identify the essential data sets required to define the state of activity of volcanoes and their plumbing systems. We explore global eruptive records in combination with heat flux and other geological and geophysical data to determine the evolutionary stage of plumbing systems. We define a Volcanic Activity Index applicable to any volcano that provides an estimate of the potential of a system to erupt in the future, which is especially important for long-quiescent volcanoes. ▪ Magmatic plumbing systems that feed volcanic activity extend across Earth's crust and are long-lived at depth and ephemeral in their shallowest portions. ▪ We revise and update the definitions of active, quiescent, and extinct volcanoes based on physical proxies for the architecture, longevity, amount, and distribution of eruptible magma in the crust. ▪ We propose a Volcanic Activity Index, which provides a relative measure of the state of activity of a volcano with respect to all other volcanoes in the world. ▪ New imaging and monitoring strategies are required to improve our ability to detect lower and middle crust magmatic processes and forecast eruptions and their potential size.
Molecular Mechanisms of Multimeric Assembly of IgM and IgA
Authors: Matsumoto Marissa L.
Published: January 2022

As central effectors of the adaptive immune response, immunoglobulins, or antibodies, provide essential protection from pathogens through their ability to recognize foreign antigens, aid in neutralization, and facilitate elimination from the host. Mammalian immunoglobulins can be classified into five isotypes—IgA, IgD, IgE, IgG, and IgM—each with distinct roles in mediating various aspects of the immune response. Of these isotypes, IgA and IgM are the only ones capable of multimerization, arming them with unique biological functions. Increased valency of polymeric IgA and IgM provides high avidity for binding low-affinity antigens, and their ability to be transported across the mucosal epithelium into secretions by the polymeric immunoglobulin receptor allows them to play critical roles in mucosal immunity. Here we discuss the molecular assembly, structure, and function of these multimeric antibodies.