bluuebunny/crossref_metadata_2025 huggingface dataset:
Agronomy Performance and Increasing of Rice Income by Integrated Crops Management (ICM) Assistance to Support Sustainable Agriculture in Bali Province
Authors: Aryawati S A N , Kamandalu A A N B , Suastika I B K , Sari A R K
Published: May 2021

Research aimed to understand the agronomy performance, rice productivity, financial feasibility and increasing of farmer’s income through program of Integrated Crops Management (ICM) assistance. Research was conducted at Tabanan Regency in 2016. Research utilized Inpari 40, Inpari 30, Inpari 16, Inpari 20, Inpari 24, Inpari 28 and Ciherang as superior rice varieties and involved 38 of farmers respondent in participating. Data of agronomy component was observed and analyzed by ANOVA. Economic feasibility of rice field farming was analyzed by using the analysis of income and R/C Ratio. Result showed that the agronomy performance of superior rice varieties cultivated with ICM technology were tend to equal to each other. Utilization of superior rice varieties with ICM technology implementation can increase rice productivity up to 1.80 ton/ha compared to farmer’s habits mainly the habit of Ciherang uses. Generally, rice field farming by ICM applications has financial feasibility supported by increasing of income average was IDR 5.640.831/ha and R/C ratio became 2.43. Implementation of ICM technology able to increase rice productivity and farmer’s income to support sustainable agriculture in Bali Province. ICM technology requires to disseminate to the farmers through assistance programs by government related that can be adopted well by farmers.
Surface Modification of Nano-Biosilica Extracted from Rice Husk using A Silane Coupling Agent
Authors: Yuliani S , Hidayat T , Wahyuningsih K , Hoerudin
Published: May 2021

Nano-biosilica extracted from rice husk, an abundant by-product of rice milling, has many potential applications in industry. However, the high amount of hydroxyl group in silica make it easy to adsorb moisture and form aggregates that are difficult to distribute in the hydrophobic matrices. This research aimed to modify the surface of nano-biosilica by using a coupling agent and characterize the changes in physical properties. Nano-biosilica was extracted using a sol–gel technique and treated with a silane coupling agent (bis-(triethoxy-silyl-propyl) tetrasulfide/TESPT) at concentrations of 0–20%. Characterization included colour (chromametry), weight increase (gravimetry), crystallinity (X-Ray Diffraction/XRD), microscopic structure (Scanning Electron Microscopy/SEM), functional groups (Fourier Transform – Infrared Spectroscopy/FT-IR), silica content (X-Ray Fluorescence Spectroscopy/XRF), and specific pore surface area (Brunauer Emmett-Teller/BET). Crystallinity decreased with the increase in silane concentration, indicating more amorphous structures of surface-modified nano-biosilica. This was confirmed by a more porous surface structure in the silane-treated nano-biosilica as shown under SEM observation. FT-IR analysis exhibited some peaks at methylene bounds at the surface-modified nano-biosilica demonstrating its interaction with TESPT. The silica content (SiO2) and the specific pore surface area of the treated nanobiosilica decreased, confirming the presence of TESPT on the surface. This study provides more potential applications of nano-biosilica as a filler agent.
Effect of Planting Time and Cassava Variety to MOCAF (Modified Cassava Flour) Quality Level
Authors: Dewi S S , Widyastuti T
Published: May 2021

The more significant demand for flour requires alternative substitute materials from local products, one of which is mocaf flour derived from cassava. The quality of mocaf flour is primarily determined by the quality of cassava. Constraints faced in the supply of mocaf flour, are influenced by the availability of cassava. On the other hand, the quality of mocaf flour is also determined by the quality of cassava produced. Therefore, it is necessary to conduct research on the content and physical properties of mocaf flour produced from differences in planting time and cassava varieties. This research was compiled using a factorial completely randomized design. There were 12 treatment combinations with 3 replications, with the first factor being cassava varieties, including varieties of Bamban, Gambyong, Gatotkaca and Kirik. The second factor is planting time, which is May, June and July. The total number of treatments was 36 treatment units. The results showed that cassava varieties with planting time in May, June and July produced mocaf flour with the content and physical properties in accordance with the Indonesian National Standard (SNI). Gatot varieties with planning time in May, June and July possess the best quality compared to other varieties.
Supersymmetry, half-bound states, and grazing incidence reflection
Authors: Patient D A , Horsley S A R
Published: May 2021

Electromagnetic waves at grazing incidence onto a planar medium are analogous to zero energy quantum particles incident onto a potential well. In this limit waves are typically completely reflected. Here we explore dielectric profiles supporting optical analogues of ‘half–bound states’, allowing for zero reflection at grazing incidence. To obtain these profiles we use two different theoretical approaches: supersymmetric quantum mechanics, and direct inversion of the Helmholtz equation, showing that discretized approximations to these profiles exhibit low reflectivity close to grazing incidence.
Modeling of non-paraxial electromagnetic wave fields with partially spatially correlated amplitude and polarization
Authors: Laverde Julián , Moreno Jaime , Castañeda Román
Published: May 2021

The non-paraxial propagation of electromagnetic wave fields seems to be a condition of the micro and nano-optics. At these scales, spatial correlation is unavoidable and occurs in two important features, i.e. the spatial coherence and spatially correlated polarization. It makes the description of the electromagnetic wave fields challenging in both mathematical formalism and physical interpretation. In this context, the algorithmic implementation of the model plays a crucial role, not only for the theoretical description but also for the experimental development, mainly by taking into account that the theoretical model is able to predict the field’s behavior and properties in experimental scenarios both accessible and still non-accessible by technology. In this paper, the basic theory of the spatially correlated electromagnetic wave fields is discussed. Its capabilities are illustrated by the predictions provided by a modular algorithm, which uses the experimental specifications as individual entries, in close resemblance to the experimental setup.
Advanced tape-exfoliated method for preparing large-area 2D monolayers: a review
Authors: Zhang Xisai , Li Yang , Mu Wenqian , Bai Wenqi , Sun Xiaoxue , Zhao Mingyu , Zhang Zhijie , Shan Fukai , Yang Zhenyu
Published: May 2021

The tape exfoliation method is still the easiest and most convenient way to obtain large-area two-dimensional (2D) monolayers in experimental research. Recently, there are some important advances in tape exfoliation method for large 2D monolayer materials. This review mainly introduced three kinds of new tape exfoliation methods including modified Scotch tape exfoliation method, metal-assisted tape exfoliation method and gel-assisted tape exfoliation method. We highlight the operation process and exfoliated mechanism of each method. We point out several problems to be solved and give an outlook on the development direction of the new tape exfoliation method. We hope this review will help researchers, especially for beginners, quickly and easily obtain a variety of 2D monolayers for their own experiments.
Preparation and properties of composite phase-change nanofiber membrane by improved bubble electrospinning
Authors: Zhao Lei , Zhao Jumei , Jiang Weiqing , Zhou Hongtao , He Jihuan
Published: May 2021

Bubble electrospinning technology can be used for mass production of nanofibers, it has been widely used in polymer electrospinning such as PVA, PVP and PAN, but there are no reports on the preparation of composite phase-change nanofibers by this method. In this paper, the transparent solution 1(PEG was put into formic acid according to the mass fraction of 60%) was mixed with the transparent solution 2 (PA66 was put into formic acid according to the mass fraction of 15%) according to the mass ratio of 15:85 , 25:75 , 35:65 and 45:55 to prepare four kinds of spinning solutions. And the pure PA66 nanofiber membrane(PNM) and PA66/PEG composite nanofiber membrane(PGCNM) were fabricated by the improved bubble electrospinning device on the basis of bubble electrospinning device invented by He Jihuan etc Also we analyzed their surface microstructure and tested their mechanical properties, thermal properties and molecular structure. The lower the content of PA66, the smaller the adhesion granular matter on the nanofiber surface and the thicker the diameter of the nanofiber, but the surface of the nanofiber is more smooth. The PGNCM appeared double absorption peak at 1515.5 cm−1and 1642 cm−1and existed weak absorption peak at 3298 cm−1 ∼ 3302 cm−1. The tensile strength and the elongation at break of the PGNCM was less than that of the PNM. The hot decomposition process of the PGNCM was composed the melting exothermic process of PEG and PA66. When the mixed ratio between PA66 and PEG was 15:85, the decomposition rate of residues between 210 ∼ 310 °C was the fastest.
The association between an early diagnosis of dementia and secondary health service use
Authors: Couch Elyse , Mueller Christoph , Perera Gayan , Lawrence Vanessa , Prina Matthew
Published: May 2021

Background

dementia policy suggests diagnosing dementia early can reduce the risk of potentially harmful hospital admissions or emergency department (ED) attendances; however, there is little evidence to support this. A diagnosis of mild cognitive impairment (MCI) before dementia is a helpful proxy to explore early diagnosis. This study investigated the association between an early diagnosis of dementia and subsequent hospitalisations and ED attendances.

Method

a retrospective cohort study of electronic health care records from 15,836 patients from a large secondary care database in South London, UK. Participants were divided into two groups: those with a diagnosis of MCI before dementia, an early diagnosis, and those without. Cox regression models were used to compare the risk of hospitalisation and ED attendance after dementia diagnosis and negative binomial regression models were used to compare the average length of stay and average number of ED attendances.

Results

participants with an early diagnosis were more likely to attend ED after their diagnosis of dementia (HR = 1.09, CI = 1.00–1.18); however, there was no difference in the number of ED attendances (IRR = 1.04, CI = 0.95–1.13). There was no difference in the risk of hospitalisation (HR = 0.99, CI = 0.91–1.08) or length of stay between the groups (IRR = 0.97, CI = 0.85–1.12).

Conclusion

the findings of this study do not support the assumption that an early diagnosis reduces the risk of hospitalisation or ED attendance. The patterns of health service use in this paper could reflect help-seeking behaviour before diagnosis or levels of co-morbidity.
The Unexceptional State: Rethinking the State in the Nineteenth Century (France, United States)
Authors: Barreyre Nicolas , Lemercier Claire
Published: May 2021

In the past thirty years, historians have deeply renewed our understanding of the state in the early republic period of the United States as much more powerful, deep reaching, and proactive than the traditional image represented. In France, too, new work has revised our vision of the state in the early nineteenth century, which looked different from the triumphant, Napoleonic leviathan that often appears in discourse. Yet both historiographies, having evolved separately, still base their conclusion on implicit comparisons, with an imagined “European” state or with a later “modern” state. This article uses the new historiographies on both countries to go beyond those unstated exceptionalisms to propose a reconstruction of the state in that period. Pulling those studies together, and mobilizing insights from one to shed light on the other, it recovers a common repertoire of statecraft that emerged in the revolutionary era. It hinged on fostering consent of key segments of the population and therefore organized the work of the state in mostly nonbureaucratic forms. States in that period reflected a particular enmeshing of public and private forms that needs to be analyzed for itself, especially if we want to understand the specificity of today’s practices.
The Empire Strikes Back from Within: Colonial Liberation and the Korean Minority Question at the Birth of Postwar Japan, 1945–47
Authors: Choi Deokhyo
Published: May 2021

The recent historiography of empire has discussed the impact of decolonization on metropolitan society, or how the “empire strikes back.” A growing literature also examines the postcolonial return migration of colonial settlers and its multifaceted aftereffects on the “home” country, bringing fresh insight into how decolonization is experienced “when empire comes home.” This article adds a different question for exploration: What does decolonization look like on the empire’s home front when colonial liberation takes place within, or when the empire strikes back from within? By examining the “liberation” of Korean imperial subjects in Japan after World War II, this article provides a unique vantage point for analyzing decolonization’s impact on metropolitan society. I will demonstrate how Japanese history can offer new insight into the convergence of two critical social phenomena regarding decolonization, namely, empire’s homecoming and colonial liberation on the empire’s home front. Moreover, this article also aims to challenge the historiographical “amnesia of empire” in the study of US-occupied Japan. I will discuss how the Korean minority question became a critical locus where US-led democratization and the postimperial transition from a multiethnic empire to the so-called monoethnic nation intersected and shaped the formation of postwar Japan.
Comparison of Relative Survival and Cause-Specific Survival in Men With Prostate Cancer According to Age and Risk Category: A Nationwide, Population-Based Study
Authors: Orrason Andri Wilberg , Garmo Hans , Styrke Johan , Dickman Paul W , Stattin Pär
Published: May 2021

Net survival, estimated in a relative survival (RS) or cause-specific survival (CSS) framework, is a key measure of the effectiveness of cancer management. We compared RS and CSS in men with prostate cancer (PCa) according to age and risk category, using Prostate Cancer data Base Sweden, including 168,793 men younger than age 90 years, diagnosed 1998–2016 with PCa. RS and CSS were compared according to age and risk category based on TNM (tumor, nodes, and metastases) stage, Gleason score, and prostate-specific antigen level. Each framework requires assumptions that are unlikely to be appropriate for PCa. Ten-year RS was substantially higher than CSS in men aged 80–89 with low-risk PCa: 125% (95% confidence interval: 113, 138) versus 85% (95% confidence interval: 82, 88). In contrast, RS and CSS were similar for men under age 70 and for all men with regional or distant metastases. Both RS and CSS produce biased estimates of net survival for men with low- and intermediate-risk PCa, in particular for men over 80. Due to biases, net survival is overestimated in analysis of RS but underestimated in analysis of CSS. These results highlight the importance of evaluating the underlying assumptions for each method, because the “true” net survival is expected to lie between the limits of RS and CSS.
Ion channels and G protein-coupled receptors as targets for invertebrate pest control: from past challenges to practical insecticides
Authors: Ozoe Yoshihisa
Published: May 2021

In the late 1970s, we discovered that toxic bicyclic phosphates inhibit the generation of miniature inhibitory junction potentials, implying their antagonism of γ-aminobutyric acid (GABA) receptors (GABARs; GABA-gated chloride channels). This unique mode of action provided a strong incentive for our research on GABARs in later years. Furthermore, minor structural changes conferred insect GABAR selectivity to this class of compounds, convincing us of the possibility of GABARs as targets for insecticides. Forty years later, third-generation insecticides acting as allosteric modulator antagonists at a distinctive site of action in insect GABARs were developed. G protein-coupled receptors (GPCRs) are also promising targets for pest control. We characterized phenolamine receptors functionally and pharmacologically. Of the tested receptors, β-adrenergic-like octopamine receptors were revealed to be the most sensitive to the acaricide/insecticide amitraz. Given the presence of multiple sites of action, ion channels and GPCRs remain potential targets for invertebrate pest control.
Past agricultural land use affects multiple facets of ungulate antipredator behavior
Authors: Bartel Savannah L , Orrock John L
Published: May 2021

Antipredator behavior affects prey fitness, prey demography, and the strength of ecological interactions. Although predator-prey interactions increasingly occur in habitats that experience multiple forms of human-generated disturbance, it is unclear how different forms of disturbance might affect antipredator behavior. Fire is a contemporary disturbance that has dramatic effects on terrestrial habitats. Such habitats may have also experienced past disturbances, like agricultural land use, that leave lasting legacies on habitat structure (e.g., overstory and understory composition). It is unclear how these past and present disturbances affect the use of different antipredator behaviors, like temporal avoidance and vigilance. We examined whether variation in disturbance regimes generates differences in ungulate antipredator behavior by using cameras to measure white-tailed deer vigilance and activity time across 24 longleaf pine woodlands that vary in past land use and contemporary fire regime. Regardless of land-use history, woodlands with high fire frequencies had 4 times less vegetation cover than low-fire woodlands, generating riskier habitats for deer; however, deer responded to fire with different antipredator strategies depending on land-use history. In nonagricultural woodlands, fire affected deer activity time such that activity was nocturnal in low-fire woodlands and crepuscular in high-fire woodlands. In post-agricultural woodlands, fire affected vigilance and not activity time such that deer were more vigilant in high-fire woodlands than in low-fire woodlands. These results suggest that ungulate antipredator behavior may vary spatially depending on past land use and contemporary fire regime, and such disturbances may generate “landscapes of fear” that persist for decades after agricultural use.
A transferable deep learning approach to fast screen potential antiviral drugs against SARS-CoV-2
Authors: Wang Shiwei , Sun Qi , Xu Youjun , Pei Jianfeng , Lai Luhua
Published: May 2021

The COVID-19 pandemic calls for rapid development of effective treatments. Although various drug repurpose approaches have been used to screen the FDA-approved drugs and drug candidates in clinical phases against SARS-CoV-2, the coronavirus that causes this disease, no magic bullets have been found until now. In this study, we used directed message passing neural network to first build a broad-spectrum anti-beta-coronavirus compound prediction model, which gave satisfactory predictions on newly reported active compounds against SARS-CoV-2. Then, we applied transfer learning to fine-tune the model with the recently reported anti-SARS-CoV-2 compounds and derived a SARS-CoV-2 specific prediction model COVIDVS-3. We used COVIDVS-3 to screen a large compound library with 4.9 million drug-like molecules from ZINC15 database and recommended a list of potential anti-SARS-CoV-2 compounds for further experimental testing. As a proof-of-concept, we experimentally tested seven high-scored compounds that also demonstrated good binding strength in docking studies against the 3C-like protease of SARS-CoV-2 and found one novel compound that can inhibit the enzyme. Our model is highly efficient and can be used to screen large compound databases with millions or more compounds to accelerate the drug discovery process for the treatment of COVID-19.
Comparative View on Social Work Education and Practices as Art and Science for China and the USA
Authors: Zhang Qingning , Tan Weihua , Lian Furong , Lee Serge C
Published: May 2021

This article provides a comparative view about the current state of social work education in China and the USA. Social work was established in the USA in 1898 and 1920 in China. In the USA, social work has been revolving in the last 122 years while in China, after the founding of the People’s Republic of China in 1949, social work was abolished from all higher education institutions. The official year that the Master of Social Work programme was reinstituted in China was 2009; and the first graduate cohort began in 2010. In this globalised twenty-first century, this article also includes how the USA and China can make social work education and its practices as art and science.
Gys1antisense therapy rescues neuropathological bases of murine Lafora disease
Authors: Ahonen Saija , Nitschke Silvia , Grossman Tamar R , Kordasiewicz Holly , Wang Peixiang , Zhao Xiaochu , Guisso Dikran R , Kasiri Sahba , Nitschke Felix , Minassian Berge A
Published: May 2021

Lafora disease is a fatal progressive myoclonus epilepsy. At root, it is due to constant acquisition of branches that are too long in a subgroup of glycogen molecules, leading them to precipitate and accumulate into Lafora bodies, which drive a neuroinflammatory response and neurodegeneration. As a potential therapy, we aimed to downregulate glycogen synthase, the enzyme responsible for glycogen branch elongation, in mouse models of the disease. We synthesized an antisense oligonucleotide (Gys1-ASO) that targets the mRNA of the brain-expressed glycogen synthase 1 gene (Gys1). We administered Gys1-ASO by intracerebroventricular injection and analysed the pathological hallmarks of Lafora disease, namely glycogen accumulation, Lafora body formation, and neuroinflammation. Gys1-ASO prevented Lafora body formation in young mice that had not yet formed them. In older mice that already exhibited Lafora bodies, Gys1-ASO inhibited further accumulation, markedly preventing large Lafora bodies characteristic of advanced disease. Inhibition of Lafora body formation was associated with prevention of astrogliosis and strong trends towards correction of dysregulated expression of disease immune and neuroinflammatory markers. Lafora disease manifests gradually in previously healthy teenagers. Our work provides proof of principle that an antisense oligonucleotide targeting the GYS1 mRNA could prevent, and halt progression of, this catastrophic epilepsy.
A Synthetic DNA Construct to Evaluate the Recovery Efficiency of Cell-Free DNA Extraction and Bisulfite Modification
Authors: Goh Su Kah , Cox Daniel R A , Wong Boris Ka Leong , Musafer Ashan , Witkowski Tom , Do Hongdo , Muralidharan Vijayaragavan , Dobrovic Alexander
Published: May 2021

Background

Despite improvements in the genetic and epigenetic analysis of cell-free DNA (cfDNA), there has been limited focus on assessing the preanalytical variables of recovery efficiency following cfDNA extraction and bisulfite modification. Quantification of recovery efficiency after these steps can facilitate quality assurance and improve reliability when comparing serial samples.

Methods

We developed an exogenous DNA Construct to Evaluate the Recovery Efficiency of cfDNA extraction and BISulfite modification (CEREBIS) after cfDNA extraction and/or subsequent bisulfite modification from plasma. The strategic placement of cytosine bases in the 180 bp CEREBIS enabled PCR amplification of the construct by a single primer set both after plasma DNA extraction and following subsequent bisulfite modification.

Results

Plasma samples derived from 8 organ transplant donors and 6 serial plasma samples derived from a liver transplant recipient were spiked with a known number of copies of CEREBIS. Recovery of CEREBIS after cfDNA extraction and bisulfite modification was quantified with high analytical accuracy by droplet digital PCR. The use of CEREBIS and quantification of its recovery was useful in identifying problematic extractions. Furthermore, its use was shown to be invaluable towards improving the reliability of the analysis of serial samples.

Conclusions

CEREBIS can be used as a spike-in control to address the preanalytical variable of recovery efficiency both after cfDNA extraction from plasma and following bisulfite modification. Our approach can be readily implemented and its application may have significant benefits, especially in settings where longitudinal quantification of cfDNA for disease monitoring is necessary.
BENviewer: a gene interaction network visualization server based on graph embedding model
Authors: Liu Yunqing , Zhu Yunchi , He Chunpeng , Lu Zuhong
Published: May 2021

BENviewer is a brand-new online gene interaction network visualization server based on graph embedding models. With mature graph embedding algorithms applied on several interaction network databases, it provides human-friendly 2D visualization based on more than 2000 biological pathways, and these results present not only genes involved but also tightness of interactions in an intuitive way. As a unique visualization server introducing graph embedding application for the first time, it is expected to help researchers gain deeper insights into biological networks beyond generating results explainable by existing knowledge. Additionally, operation flow for users is simplified to greater extent in its current version; meanwhile URL optimization contributes to data acquisition in batch for further analysis. BENviewer is freely available at http://www.bmeonline.cn/BENviewer, besides it is open-sourced at https://github.com/SKLB-lab/BENviewer, http://benviewer.bmeonline.cn.
Empiric proton pump inhibitor therapy after esophageal food impaction may mask eosinophilic esophagitis diagnosis at follow-up
Authors: Hillman Luke , Donohue Sarah , Broman Aimee Teo , Hoversten Patrick , Gaumnitz Eric , Lomeli Luis
Published: May 2021

Esophageal food impaction (EFI) is often the first presentation for patients with eosinophilic esophagitis (EoE); however, there is significant heterogeneity in the management of EFI. We aimed to study the impact of EFI management, particularly post-EFI medication prescriptions on EoE diagnosis, follow-up, and recurrence in patients with endoscopic features of EoE. In our retrospective study, adults presenting between 2007 and 2017 with EFI requiring endoscopic dis-impaction with endoscopic features of EoE (furrows, rings, and/or exudates) were included. We examined the impact of demographics and EFI management on EoE diagnosis, follow-up (esophagogastroduodenoscopy [EGD] or clinic visit within 6 months), and recurrence. We identified 164 cases of EFI due to suspected EoE. Biopsy was performed in 68 patients (41.5%), and 144 patients (87.8%) were placed on proton pump inhibitor (PPI) and/or swallow corticosteroids after EFI, including 88.5% of those not biopsied. PPI use at time of biopsy was negatively associated with EoE diagnosis (odds ratio: 0.39, confidence interval: 0.17–0.85). Sixty-one (37.4%) patients were lost to follow-up at 6 months. Recurrent EFI at 1 year occurred in 3.7% of patients. Medications, most commonly PPI, are frequently prescribed after EFI when the endoscopic features of EoE are present, which may mask the diagnosis of EoE on follow-up EGD. We estimated that for every five patients biopsied on PPI, one case of EoE is masked. As recurrent EFI within 1 year is uncommon, empiric therapy should be avoided until diagnostic biopsies are obtained. Further efforts to reduce loss to follow-up after EFI are also needed.
Risk stratification of ulcer-like projection in uncomplicated acute type B aortic intramural haematoma
Authors: Chen Lyufan , Yang Fan , Liu Jitao , Luo Songyuan , Yuan Hui , Fan Ruixin , Zeng Hongke , Geng Qingshan , Luo Jianfang
Published: May 2021

OBJECTIVES

This study aimed to investigate the morphological evolution and risk stratification of ulcer-like projection (ULP) in patients with uncomplicated acute type B aortic intramural haematoma.

METHODS

A retrospective study was conducted on patients with uncomplicated acute type B intramural haematoma admitted in our institution from January 2015 to June 2020. The primary end points were adverse aortic events (AAE), including aortic rupture, aortic dissection, aortic aneurysm and ULP enlargement.

RESULTS

The study cohort comprised 140 patients, including 62 (44%) and 78 (56%) patients with and without initial ULP, respectively. AAE occurred in 13 patients (9%) in the early term and 42 patients (33%) in the mid-term. Compared with patients without ULP, patients with initial ULP had no significant difference in early outcomes but a higher mid-term AAE rate [8% vs 11%, odds ratio (OR) 1.5, P = 0.47; 17% vs 55%, OR 6.0, P < 0.001]. Significantly higher AAE rate was observed in patients with high-risk ULP (depth ≥5.0 mm and located in the proximal aortic segments) than those with only low-risk ULP (depth <5.0 mm and/or located in the distal aortic segments) (87% vs 51%, OR 6.2, P = 0.014). In the multivariable analysis, high-risk ULP was an independent predictor of AAE (hazard ratio 2.8, P = 0.009).

CONCLUSIONS

High-risk ULP is a rapidly evolving entity and a marker of AAE despite optimal medical therapy. Therefore, close follow-up and prompt intervention are recommended for patients with high-risk ULP.
Lower risk of stroke after alcohol abstinence in patients with incident atrial fibrillation: a nationwide population-based cohort study
Authors: Lee So-Ryoung , Choi Eue-Keun , Jung Jin-Hyung , Han Kyung-Do , Oh Seil , Lip Gregory Y H
Published: May 2021

Aims 

The aim of this study was to evaluate the association between alcohol consumption status (and its changes) after newly diagnosed atrial fibrillation (AF) and the risk of ischaemic stroke.

Methods and results 

Using the Korean nationwide claims and health examination database, we included subjects who were newly diagnosed with AF between 2010 and 2016. Patients were categorized into three groups according to the status of alcohol consumption before and after AF diagnosis: non-drinkers; abstainers from alcohol after AF diagnosis; and current drinkers. The primary outcome was incident ischaemic stroke during follow-up. Non-drinkers, abstainers, and current drinkers were compared using incidence rate differences after the inverse probability of treatment weighting (IPTW). Among a total of 97 869 newly diagnosed AF patients, 51% were non-drinkers, 13% were abstainers, and 36% were current drinkers. During 310 926 person-years of follow-up, 3120 patients were diagnosed with incident ischaemic stroke (10.0 per 1000 person-years). At 5-year follow-up, abstainers and non-drinkers were associated with a lower risk for stroke than current drinkers (incidence rate differences after IPTW, −2.03 [−3.25, −0.82] for abstainers and −2.98 [−3.81, −2.15] for non-drinkers, per 1000 person-years, respectively; and incidence rate ratios after IPTW, 0.75 [0.70, 0.81] for non-drinkers and 0.83 [0.74, 0.93] for abstainers, respectively).

Conclusion 

Current alcohol consumption was associated with an increased risk of ischaemic stroke in patients with newly diagnosed AF, and alcohol abstinence after AF diagnosis could reduce the risk of ischaemic stroke. Lifestyle intervention, including attention to alcohol consumption, should be encouraged as part of a comprehensive approach to AF management to improve clinical outcomes.
Multiple house occupancy is associated with mortality in hospitalized patients with COVID-19
Authors: Bruce Eilidh , Carter Ben , Quinn Terence J , Verduri Alessia , Pearson Oliver , Vilches-Moraga Arturo , Price Angeline , McGovern Aine , Evans Louis , McCarthy Kathryn , Hewitt Jonathan , Moug Susan , Myint Phyo K ,   COPE Study Team
Published: May 2021

Background

In response to the COVID-19 pandemic, many countries mandated staying at home to reduce transmission. This study examined the association between living arrangements (house occupancy numbers) and outcomes in COVID-19.

Methods

Study population was drawn from the COPE study, a multicentre cohort study. House occupancy was defined as: living alone; living with one other person; living with multiple other people; or living in a nursing/residential home. Outcomes were time from admission to mortality and discharge (Cox regression), and Day 28 mortality (logistic regression) analyses were adjusted for key comorbidities and covariates including admission: age, sex, smoking, heart failure, admission C-reactive protein (CRP), chronic obstructive pulmonary disease, estimated glomerular filtration rate, frailty and others.

Results

A total of 1584 patients were included from 13 hospitals across UK and Italy: 676 (42.7%) were female, 907 (57.3%) were male, median age was 74 years (range: 19–101). At 28 days, 502 (31.7%) had died. Median admission CRP was 67, 82, 79.5 and 83 mg/l for those living alone, with someone else, in a house of multiple occupancy and in a nursing/residential home, respectively. Compared to living alone, living with anyone was associated with increased mortality: within a couple [adjusted hazard ratios (aHR) = 1.39, 95% confidence intervals (CI) 1.09–1.77, P = 0.007]; living in a house of multiple occupancy (aHR = 1.67, 95% CI 1.17–2.38, P = 0.005); and living in a residential home (aHR = 1.36, 95% CI 1.03–1.80, P = 0.031).

Conclusion

For patients hospitalized with COVID-19, those living with one or more people had an increased association with mortality, they also exhibited higher CRP indicating increased disease severity suggesting they delayed seeking care.
Frailty screening in older adults: is annual screening necessary in primary care?
Authors: Lee Linda , Jones Aaron , Hillier Loretta M , Costa Andrew , Patel Tejal , Parikh Ruchi
Published: May 2021

Background

The Case-finding for Complex Chronic Conditions in Adults 75+ (C5-75) involves annual frailty screening in primary care using dual-trait screening measures of handgrip strength and gait speed, with additional screening for co-existing conditions in those deemed frail.

Objective

To identify low-risk individuals who could be screened for frailty every 2 years, rather than annually.

Methods

This study examined a prospective cohort of patients who completed at least two annual C5-75 screenings between April 2014 and December 2018. Handgrip strength and gait speed on initial assessment were categorized based on proximity to frailty thresholds and were used to predict frailty risk on the second assessment. We used Fisher’s exact test to assess differences in risk. Logistic regression models tested associations between independent variables of age, patient activity level, falls history, grip strength and gait speed on first assessment and dependent variable of frailty on subsequent assessment.

Results

Analyses included 571 patients with two annual assessments. Frailty risk on the second assessment was significantly higher for patients who had gait speed or grip strength within 20% of the frailty threshold (5.7%), compared with the other categories (0.7%, 0.9%, 0%; P = 0.002); 60% of patients fell within these lower risk categories. Controlling for grip strength and gait speed, no other measures had significant associations with frailty risk.

Conclusions

Our results demonstrate that 60% patients are at low risk (<1%) of transitioning to frailty by the next annual assessment. Reducing screening frequency from annually to every 2 years may be appropriate for these patients.
Knowledge exchange under asymmetric information in emerging economies: impact of signals from Indian universities
Authors: Ray Amit S , Sengupta Abhijit
Published: May 2021

Emerging and developing countries are characterized by severe information asymmetries in knowledge markets, which when combined with other institutional weaknesses, lead to very low levels of interactions between universities and industry. Using data from a sample of Indian universities, we identify university-specific publicly available organizational characteristics which, acting as “signals,” may reduce the information asymmetry problem and catalyze knowledge exchange (KE) partnerships. We find that strength of passive signals such as university ownership structure and reputation, and active ones such as volume of patents filed, impacts a university’s KE performance positively. The impact of each signal is very KE channel specific, and the magnitude of this impact is large. We also find that signal strength negatively moderates the direct linkage between research and KE, implying that signaling is more relevant for universities where there is greater separation of its research outputs and KE performance.
The characteristics of distal tears affect false lumen thrombosis rate after thoracic endovascular aortic repair for acute type B dissection
Authors: Li Da , Yuan Ding , Peng Liqing , Zheng Tinghui , Fan Yubo
Published: May 2021

OBJECTIVES

A low false lumen thrombosis rate (FLTR) is common in patients with type B aortic dissection after they have undergone thoracic endovascular aortic repair, which indicates a poor long-term prognosis. This study aimed to establish a quantitative linear regression model to predict false lumen (FL) thrombosis accurately using morphological parameters.

METHODS

In this retrospective study, we included 59 patients diagnosed with acute type B aortic dissection between 2014 and 2017. Morphological parameters were measured. Univariable and multivariable linear regression analyses were performed, and a linear regression model relating FLTR with the number of re-entry tears was proposed. Ten patients were further chosen to validate the linear relationship, and idealized aortic dissection models were adopted for haemodynamic analysis.

RESULTS

Only the total area and number of re-entry tears were negatively correlated with FL thrombosis (P < 0.001). Moreover, based on the univariable regression, the number of re-entry tears played a more crucial role in FLTR (R2 = 0.509 vs R2 = 0.298), and the linear relationship model was created as follows: thrombosis rate (%) = −11.25 × distal tear number + 105.24. This model was perfectly matched in 10 patients (concordance correlation coefficient = 0.880, P = 0.947). Moreover, when the total area of re-entry tears was constant, the net blood flow increased rapidly with an increase in the tear count.

CONCLUSIONS

The number of re-entry tears could be a crucial related factor of FL thrombosis; the larger the number of re-entry tears is, the lower the possibility of thrombosis is.
Data and Safety Monitoring of COVID-19 Vaccine Clinical Trials
Authors: Joffe Steven , Babiker Abdel , Ellenberg Susan S , Fix Alan , Griffin Marie R , Hunsberger Sally , Kalil Jorge , Levine Myron M , Makgoba Malegapuru W , Moore Reneé H , Tsiatis Anastasios A , Whitley Richard
Published: May 2021

To speed the development of vaccines against SARS-CoV-2, the United States Federal Government has funded multiple phase 3 trials of candidate vaccines. A single 11-member data and safety monitoring board (DSMB) monitors all government-funded trials to ensure coordinated oversight, promote harmonized designs, and allow shared insights related to safety across trials. DSMB reviews encompass 3 domains: (1) the conduct of trials, including overall and subgroup accrual and data quality and completeness; (2) safety, including individual events of concern and comparisons by randomized group; and (3) interim analyses of efficacy when event-driven milestones are met. Challenges have included the scale and pace of the trials, the frequency of safety events related to the combined enrollment of over 100 000 participants, many of whom are older adults or have comorbid conditions that place them at independent risk of serious health events, and the politicized environment in which the trials have taken place.
Modeling the Impacts of Clinical Influenza Testing on Influenza Vaccine Effectiveness Estimates
Authors: Feldstein Leora R , Ferdinands Jill M , Self Wesley H , Randolph Adrienne G , Aboodi Michael , Baughman Adrienne H , Brown Samuel M , Exline Matthew C , Clark Files D , Gibbs Kevin , Ginde Adit A , Gong Michelle N , Grijalva Carlos G , Halasa Natasha , Khan Akram , Lindsell Christopher J , Newhams Margaret , Peltan Ithan D , Prekker Matthew E , Rice Todd W , Shapiro Nathan I , Steingrub Jay , Talbot H Keipp , Halloran M Elizabeth , Patel Manish
Published: May 2021

Background

Test-negative design studies for evaluating influenza vaccine effectiveness (VE) enroll patients with acute respiratory infection. Enrollment typically occurs before influenza status is determined, resulting in over-enrollment of influenza-negative patients. With availability of rapid and accurate molecular clinical testing, influenza status could be ascertained before enrollment, thus improving study efficiency. We estimate potential biases in VE when using clinical testing.

Methods

We simulate data assuming 60% vaccinated, 25% of those vaccinated are influenza positive, and VE of 50%. We show the effect on VE in 5 scenarios.

Results

Vaccine effectiveness is affected only when clinical testing preferentially targets patients based on both vaccination and influenza status. Vaccine effectiveness is overestimated by 10% if nontesting occurs in 39% of vaccinated influenza-positive patients and 24% of others. VE is also overestimated by 10% if nontesting occurs in 8% of unvaccinated influenza-positive patients and 27% of others. Vaccine effectiveness is underestimated by 10% if nontesting occurs in 32% of unvaccinated influenza-negative patients and 18% of others.

Conclusions

Although differential clinical testing by vaccine receipt and influenza positivity may produce errors in estimated VE, bias in testing would have to be substantial and overall proportion of patients tested would have to be small to result in a meaningful difference in VE.
Cost-effectiveness of public caseload midwifery compared to standard care in an Australian setting: a pragmatic analysis to inform service delivery
Authors: Callander Emily J , Slavin Valerie , Gamble Jenny , Creedy Deera K , Brittain Hazel
Published: May 2021

Background

Decision-makers need quantifiable data on costs and outcomes to determine the optimal mix of antenatal models of care to offer. This study aimed to examine the cost utility of a publicly funded Midwifery Group Practice (MGP) caseload model of care compared to other models of care and demonstrate the feasibility of conducting such an analysis to inform service decision-making.

Objective

To provide a methodological framework to determine the value of public midwifery in different settings.

Methods

Incremental costs and incremental utility (health gains measured in quality-adjusted life years (QALYs)) of public MGP caseload were compared to other models of care currently offered at a large tertiary hospital in Australia. Patient Reported Outcomes Measurement Information System Global Short Form scores were converted into utility values by mapping to the EuroQol 5 dimensions and then converting to QALYs. Costs were assessed from a health system funder’s point of view.

Results

There were 85 women in the public MGP caseload care group and 72 received other models of care. Unadjusted total mean cost for mothers’ and babies’ health service use from study entry to 12 months post-partum was $27 618 for MGP caseload care and $33 608 for other models of care. After adjusting for clinical and demographic differences between groups, total costs were 22% higher (cost ratio: 1.218, P = 0.04) for other models of maternity care. When considering costs to all funders, public MGP caseload care cost $5208 less than other models of care. There was no significant difference in QALY between the two groups (difference: 0.010, 95% CI: −0.038, 0.018).

Conclusion

Public MGP caseload care costs 22% less than other models of care, after accounting for differences in baseline characteristics between groups. There were no significant differences in QALYs. Public MGP caseload care produced comparable health outcomes, with some indication that outcomes may be better for lower cost per woman.
Efficacy and safety of sofosbuvir/velpatasvir versus the standard of care in adults hospitalized with COVID-19: a single-centre, randomized controlled trial
Authors: Sayad Babak , Khodarahmi Reza , Najafi Farid , Miladi Ronak , Mohseni Afshar Zeinab , Mansouri Feizollah , Rahimi Zohreh , Shirvani Maria , Salimi Mehdi , Vaziri Siavash , Janbakhsh Alireza , Khosravi Shadmani Fatemeh , Bozorgomid Arezoo , Zamanian Mohammad Hossein , Afsharian Mandana
Published: May 2021

Objectives

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the COVID-19 pandemic. The majority of patients experience asymptomatic to mild self-limited disease, but some cases progress to respiratory and multi-organ failure. However, so far, no approved antiviral therapy has been available for treatment of COVID-19. Sofosbuvir/velpatasvir (SOF/VEL) is an approved anti-HCV drug that is capable of suppressing other families of positive-sense RNA viruses with conserved polymerase and may be effective against SARS-CoV-2. This study was conducted to evaluate the efficacy of the SOF/VEL combination in addition to the national standard of care versus the national standard of care alone (hydroxychloroquine and lopinavir/ritonavir as well as supportive care) in patients with moderate to severe COVID-19 infection.

Methods

This single-centre, randomized, open-labelled, prospective clinical trial was done in patients with moderate to severe COVID-19 admitted to Farabi Hospital in Kermanshah Province, Iran. Eligible patients were randomly assigned in a 1:1 ratio to the SOF/VEL arm (SOF/VEL plus the national standard of care) or the control arm (the national standard of care alone). The main outcome of the study was the mortality on Day 28 after randomization. Secondary outcomes were time from the start of medication to clinical improvement, hospital length of stay, need for mechanical ventilation, duration of mechanical ventilation and conversion of RT–PCR results from positive to negative from the time of randomization to discharge. Adverse events were evaluated in all patients who started their assigned treatment.

Results

Between 11 April and 8 June 2020, 80 patients were recruited and randomly assigned into the SOF/VEL (n = 40) and control (n = 40) arms. The primary outcome was not significantly different between the two arms (P = 1.00). Secondary outcomes, including time to clinical improvement, hospital length of stay, need for mechanical ventilation, duration of mechanical ventilation and RT–PCR conversion, were not significantly different between arms either (P > 0.05). SOF/VEL treatment and the national standard of care were tolerated similarly.

Conclusions

Although treatment with SOF/VEL was safe, adding SOF/VEL to the standard of care did not improve the clinical status or reduce mortality in patients with moderate to severe COVID-19. However, larger randomized clinical trials including more parameters are needed for accurate estimation of the efficacy of SOF/VEL.