bluuebunny/crossref_metadata_2025 huggingface dataset:
Henagliflozin monotherapy in patients with type 2 diabetes inadequately controlled on diet and exercise: A randomized, double‐blind, placebo‐controlled, phase 3 trial
Authors: Lu Juming , Fu Liujun , Li Yan , Geng Jianlin , Qin Li , Li Ping , Zheng Hailong , Sun Zilin , Li Yanbing , Zhang Lihui , Sun Yadong , Chen Daoxiong , Qin Guijun , Lu Weiping , Guo Yushan , Zhang Yuwei , Liu Haiyan , Zhang Tao , Zou Jianjun
Published: January 2021

Aim

To evaluate henagliflozin, a novel sodium‐glucose co‐transporter‐2 inhibitor, as monotherapy in patients with type 2 diabetes and inadequate glycaemic control with diet and exercise.

Materials and Methods

This multicentre trial included a 24‐week, randomized, double‐blind, placebo‐controlled period, followed by a 28‐week extension period. Four hundred and sixty‐eight patients with an HbA1c of 7.0%–10.5% were randomly assigned (1:1:1) to receive once‐daily placebo, or 5 or 10 mg henagliflozin. After 24 weeks, patients on placebo were switched to 5 or 10 mg henagliflozin, and patients on henagliflozin maintained the initial therapy. The primary endpoint was the change in HbA1c from baseline after 24 weeks.

Results

At Week 24, the placebo‐adjusted least squares (LS) mean changes from baseline in HbA1c were −0.91% (95% CI: −1.11% to −0.72%; P < .001) and −0.94% (−1.13% to −0.75%; P < .001) with henagliflozin 5 and 10 mg, respectively; the placebo‐adjusted LS mean changes were −1.3 (−1.8 to −0.9) and −1.5 (−2.0 to −1.1) kg in body weight, and −5.1 (−7.2 to −3.0) and −4.4 (−6.5 to −2.3) mmHg in systolic blood pressure (all P < .05). The trends of these improvements were sustained for an additional 28 weeks. Adverse events occurred in 81.0%, 78.9% and 78.9% of patients in the placebo, henagliflozin 5 and 10 mg groups, respectively. No diabetic ketoacidosis or major episodes of hypoglycaemia occurred.

Conclusions

Henagliflozin 5 mg and 10 mg as monotherapy provided effective glycaemic control, reduced body weight and blood pressure, and was generally well tolerated.
Fasting oxyntomodulin, glicentin, and gastric inhibitory polypeptide levels are associated with activation of reward‐ and attention‐related brain centres in response to visual food cues in adults with obesity: A cross‐sectional functional MRI study
Authors: Perakakis Nikolaos , Farr Olivia M. , Mantzoros Christos S.
Published: January 2021

Postprandial increases in gastrointestinal hormones are associated with reduced energy intake, partially through direct effects on the brain. However, it remains unknown whether the fasting levels of gastrointestinal hormones are associated with altered brain activity in response to visual food stimuli. We therefore performed a whole‐brain regression cross‐sectional analysis to assess the association between fasting brain activations according to functional magnetic resonance imaging, performed during viewing of highly desirable versus less desirable food images, with fasting levels of five gastrointestinal hormones (glucagon‐like peptide [GLP]‐1, GLP‐2, oxyntomodulin, glicentin and gastric inhibitory polypeptide [GIP]) in 36 subjects with obesity. We observed that fasting blood levels of GIP were inversely associated with the activation of attention‐related areas (visual cortices of the occipital lobe, parietal lobe) and of oxyntomodulin and glicentin with reward‐related areas (insula, putamen, caudate for both, and additionally orbitofrontal cortex for glicentin) and the hypothalamus when viewing highly desirable as compared to less desirable food images. Future studies are needed to confirm whether fasting levels of oxyntomodulin, glicentin and GIP are associated with the activation of brain areas involved in appetite regulation and with energy intake in people with obesity.
Ontogenetic divergence generates novel phenotypes in hybrid cichlids
Authors: Santos‐Santos Javier H. , Audenaert Leen , Verheyen Erik , Adriaens Dominique
Published: January 2021

Hybridization is suggested to contribute to ecomorphological and taxonomic diversity in lacustrine East African cichlids. This is supported by studies demonstrating that genetic diversity within lake radiations has been influenced by hybridization events, leading to extensive phenotypic differentiation of genetically closely related species. Hybrid persistence and speciation in sympatry with gene flow can be explained by pleiotropy in traits involved in reproductive isolation; however, little attention has been given to how trait differentiation is established during hybrid ontogeny, and how this may relate to trophic and locomotor specialization. This study compares body shape changes in a Lake Victoria cichlid hybrid throughout its post‐hatch ontogeny to those of its parental species. Across the considered age/size categories, hybrids occupy a distinct and intermediate morphological space, yet where several transgressive traits emerge. A between‐group principal component analysis on body shapes across size categories reveals axes of shape variation exclusive to the hybrids in the youngest/smallest size categories. Shape differences in the hybrids involved morphological traits known to be implicated in trophic and locomotor specializations in the parental species. Combined, our findings suggest that phenotypic divergence in the hybrid can lead to functional differences that may potentially release them to some degree from competition with the parental species. These findings agree with recent literature that addresses the potential importance of hybridization for the unusually recent origin of the Lake Victoria cichlid super‐species flock.
Optimal income taxation with tax avoidance
Authors: Casamatta Georges
Published: January 2021

We determine the optimal income tax schedule when individuals have the possibility of avoiding paying taxes. Considering a convex concealment cost function, we find that a subset of individuals, located in the interior of the income distribution, should be allowed to avoid taxes, provided that the marginal cost of avoiding the first euro is sufficiently small. This contrasts with the results of Grochulski who shows that, using a subadditive cost function, all individuals should report their true income. We also provide a characterization of the optimal income tax curve.
Child Marriage in Canada
Authors: Koski Alissa , Clark Shelley
Published: January 2021

Child marriage, defined as formal or informal marriage before the age of 18, is a globally recognized indicator of gender inequality. Canada has placed itself at the forefront of global efforts to end child marriage as part of its commitment to the United Nations Sustainable Development Goals. Despite these global aspirations, child marriage remains legal throughout Canada. Data from vital statistics agencies and recent censuses indicate that child marriage, although rare, is practiced across the country. In 2016, nearly 2,300 children between 15 and 17 years of age were in union, a prevalence of 0.2 percent. The vast majority (98 percent) of these were informal, common‐law unions. Demographic patterns of child marriage in Canada are similar to those observed in many low‐ and middle‐income countries. Girls were far more likely to be married as children than boys and typically wed much older spouses. There were marked differences in the prevalence of child marriage across the country, with the highest estimates found in Alberta, Manitoba, Saskatchewan, and the territories. These findings draw attention to the discrepancy between Canada's domestic law and its foreign policy. They also highlight thorny challenges inherent in efforts to eradicate this practice in Canada and elsewhere.
Effects of heat treatment on metabolism of tobacco plants infected with Potato virus Y
Authors: Hýsková V. , Bělonožníková K. , Doričová V. , Kavan D. , Gillarová S. , Henke S. , Synková H. , Ryšlavá H. , Čeřovská N.
Published: January 2021

Many factors affect successful virus propagation and plant defence responses. Heat shock protein (Hsp) expression after heat shock plays an ambiguous role in viral infection. On the one hand, Hsp70 participates in plant defence response; on the other hand, Hsp70 could interact with viral proteins and facilitate virus propagation.

Here, we studied metabolic adaptations of Nicotiana tabacum L. subjected to heat shock (42 °C, 2 h) before or after inoculating the plants with Potato virus Y (potyvirus).

RT‐qPCR and ELISA were used for potyvirus quantification. Hsp70 and Hsp90 isoforms were analysed by Western blotting. Salicylic, quinic and chlorogenic acid content was determined by LC‐MS. The activity of Hatch–Slack enzymes (as markers of potyviral infection in tobacco) and glycosidases was assayed.

Application of heat shock before or after inoculation showed accelerated potyviral propagation in comparison with only inoculated plants. Plants exposed to heat shock and concurrently inoculated showed higher potyviral content, higher amount of Hsp70, together with late decline of quinic acid content and low chlorogenic acid content. Spread of potyviral infection correlated with enhanced salicylic acid content and activities of enzymes of the Hatch–Slack cycle, α‐ and β‐galactosidase, α‐mannosidase, α‐glucosidase and β‐N‐acetylhexosaminidase.

Heat shock proteins accelerate potyviral propagation. The lower weight cytosolic and mitochondrial Hsp70 (~50‐75 kDa) persist throughout the viral infection. Also, the plant defense response results in increase of salicylic and chlorogenic acids but decrease of quinic acid content.
Effects of applying biochar and straw on nitrate leaching and maize yield production
Authors: Partovi Zahra , Ramezani Etedali Hadi , Kaviani Abbas
Published: January 2021

The aim of this study was to investigate the effect of biochar and wheat straw on nitrogen leaching and corn yield. Field experiment includes CO (control treatment), SM5 and SM10 (wheat straw with a thickness of 5 and 10 mm, respectively), ST5 and ST10 (wheat straw at a rate of 5 and 10 t ha−1 in combination with soil, respectively) and BT2.5 and BT5 (biochar at a rate of 2.5 t ha−1 in combination with soil). Results showed that the total amount of leached nitrate in BT5, SM10, BT2.5 and ST5 treatments decreased by 71%, 55%, 50% and 32%, respectively, compared to CO. Also, the increasing biochar application rate (BT5) led to enhance 28% in maize grain yield and reduce deep percolation, nitrate and nitrite leaching by 31%, 71% and 97%, respectively. Therefore, it seems that the use of bioshar and straw reduces nitrate leaching, improves soil moisture conditions and increases corn yield.
Removal of ammonia nitrogen in aquaculture wastewater by composite photocatalyst TiO2/carbon fibre
Authors: Yu Runqiang , Yu Xiaocai , Fu Jiayuan , Zhang Yongxia , Liu Yifu , Zhang Yuqi , Wu Shini
Published: January 2021

In this study, TiO2/Carbon fibre (CF) composite photocatalyst was prepared by sol‐gel method, and its characterization was analysed by SEM and XRD. Under the ultraviolet light, the effects of various single factors on the removal of ammonia nitrogen from aquaculture wastewater by TiO2/CF were discussed. Orthogonal experiments were performed to determine the most beneficial conditions for ammonia nitrogen removal. When the dosage of TiO2/CF was 2.0 g/L, the initial concentration of ammonia nitrogen was 30 mg/L, the calcination temperature was 600°C, the concentration of H2O2was 0.8 g/L, the illumination time was 1 hr, TiO2/CF had excellent performance of remove ammonia nitrogen. The results show that compared with the treatment of ammonia nitrogen by CF or TiO2, TiO2/CF was more effective in the removal of ammonia nitrogen. TiO2/CF composite material was applied to the treatment of ammonia nitrogen in marine aquaculture wastewater for the first time, which provides a scientific and effective treatment method for photocatalytic technology in later industrial treatment process.
Generic rank of Betti map and unlikely intersections
Authors: Gao Ziyang
Published: January 2021

Let $\mathcal {A} \rightarrow S$ be an abelian scheme over an irreducible variety over $\mathbb {C}$ of relative dimension $g$. For any simply-connected subset $\Delta$ of $S^{\mathrm {an}}$ one can define the Betti map from $\mathcal {A}_{\Delta }$ to $\mathbb {T}^{2g}$, the real torus of dimension $2g$, by identifying each closed fiber of $\mathcal {A}_{\Delta } \rightarrow \Delta$ with $\mathbb {T}^{2g}$ via the Betti homology. Computing the generic rank of the Betti map restricted to a subvariety $X$ of $\mathcal {A}$ is useful to study Diophantine problems, e.g. proving the geometric Bogomolov conjecture over char $0$ and studying the relative Manin–Mumford conjecture. In this paper we give a geometric criterion to detect this rank. As an application we show that it is maximal after taking a large fibered power (if $X$ satisfies some conditions); it is an important step to prove the bound for the number of rational points on curves (Dimitrov et al., Uniformity in Mordell–Lang for Curves, Preprint (2020), arXiv:2001.10276). Another application is to answer a question of André, Corvaja and Zannier and improve a result of Voisin. We also systematically study its link with the relative Manin–Mumford conjecture, reducing the latter to a simpler conjecture. Our tools are functional transcendence and unlikely intersections for mixed Shimura varieties.
Experimental Structural Stiffness Analysis of a Surgical Haptic Master Device Manipulator
Authors: Görgülü İbrahimcan , Can Dede Mehmet İsmet , Carbone Giuseppe
Published: January 2021

This paper deals with haptic devices for master–slave telesurgical applications. Namely, a stiffness model fitting methodology and its fine-tuning are proposed based on experimental results. In particular, the proposed procedure is based on virtual joint structural stiffness modeling to be applied in time-efficient compliance compensation strategies. A specific case study is discussed by referring to the HISS haptic device that has been developed and built at Izmir Institute of Technology. Two different experimental setups are designed for stiffness evaluation tests. Experimental results are discussed to demonstrate their implementation in the proposed methodology for the fine-tuning of stiffness model.
Transfer Case Clutch Torque Modeling and Validation Under Slip and Overtaken Conditions
Authors: Wei Wenpeng , Dourra Hussein , Zhu Guoming
Published: January 2021

The vehicle transfer case clutch plays an important role for four-wheel drive (4WD) vehicles since the torque transmitted through the clutch determines the amount of traction torque on tires, which is important for vehicle performance. However, the clutch torque measurement is usually unavailable on production vehicles and needs to be estimated accurately to improve vehicle performance. This paper proposes a unified scheme to model clutch output torque under all three conditions: open (no torque output), slipping, and overtaken. Specifically, the clutch torque model under clutch overtaken condition is first investigated using the vehicle longitudinal and tire dynamics. It was found that effective radius of front tires, powered by the transfer case clutch torque, cannot be assumed as constant and should be compensated by vehicle acceleration, while the effective radius of rear tires connected directly to the propulsion system does not need to be compensated. In addition, it was found that torque model under clutch overtaken condition cannot be used under slip condition. As a result, a general clutch torque model is developed for both slip and overtaken conditions with a clutch slip speed compensation, resulting a root-mean-square error percentage (RMSE%) of 6.8% comparing with the experimental measurement data. Note that overtaken torque model is a special case of the general torque model by setting slip speed equal to zero. The general clutch torque model is able to calculate clutch output torque accurately under both slip and overtaken conditions.
Control of Uniflagellar Soft Robots at Low Reynolds Number Using Buckling Instability
Authors: Forghani Mojtaba , Huang Weicheng , Jawed M. Khalid
Published: January 2021

In this paper, we analyze the inverse dynamics and control of a bacteria-inspired uniflagellar robot in a fluid medium at low Reynolds number. Inspired by the mechanism behind the locomotion of flagellated bacteria, we consider a robot comprising a flagellum—a flexible helical filament—connected to a spherical head. The flagellum rotates about the head at a controlled angular velocity and generates a propulsive force that moves the robot forward. When the angular velocity exceeds a threshold value, the hydrodynamic force exerted by the fluid can cause the soft flagellum to buckle, characterized by a dramatic change in its shape. In this computational study, a fluid–structure interaction model that combines Discrete Elastic Rods algorithm with Lighthill's Slender Body Theory is employed to simulate the locomotion and deformation of the robot. We demonstrate that the robot can follow a prescribed path in three-dimensional space by exploiting buckling of the flagellum. The control scheme involves only a single (binary) scalar input—the angular velocity of the flagellum. By triggering the buckling instability at the right moment, the robot can follow the path in three-dimensional space. We also show that the complexity of the dynamics of the helical filament can be captured using a deep neural network, from which we identify the input–output functional relationship between the control input and the trajectory of the robot. Furthermore, our study underscores the potential role of buckling in the locomotion of natural bacteria.
Experimental Characterization of Two-Phase Cooling of Power Electronics in Thermosiphon and Forced Convection Modes
Authors: Battaglia Fabio , Singer Farah , Deisenroth David C. , Ohadi Michael M.
Published: January 2021

In this paper, we present the results of an experimental study involving low thermal resistance cooling of high heat flux power electronics in a forced convection mode, as well as in a thermosiphon (buoyancy-driven) mode. The force-fed manifold microchannel cooling concept was utilized to substantially improve the cooling performance. In our design, the heat sink was integrated with the simulated heat source, through a single solder layer and substrate, thus reducing the total thermal resistance. The system was characterized and tested experimentally in two different configurations: the passive (buoyancy-driven) loop and the forced convection loop. Parametric studies were conducted to examine the role of different controlling parameters. It was demonstrated that the thermosiphon loop can handle heat fluxes in excess of 200 W/cm2 with a cooling thermal resistance of 0.225 (K cm2)/W for the novel cooling concept and moderate fluctuations in temperature. In the forced convection mode, a more uniform temperature distribution was achieved, while the heat removal performance was also substantially enhanced, with a corresponding heat flux capacity of up to 500 W/cm2 and a thermal resistance of 0.125 (K cm2)/W. A detailed characterization leading to these significant results, a comparison between the performance between the two configurations, and a flow visualization in both configurations are discussed in this paper.
Design, Fabrication, and Testing of a Novel Design for Flexible Light-Emitting Diode Signage Modules
Authors: Adhikari Ram C. , Beyragh Dawood S. , Pahlevani Majid
Published: January 2021

This paper presents a new design architecture for mechanically flexible light-emitting diode (LED) signage modules for applications in digital advertising on curved surfaces. The new design comprises an array of commonly used rigid printed circuit boards (PCBs) but of smaller size with some spacing between them, which is encapsulated by a flexible substrate or potting material, instead of a large single rigid PCB in the entire LED module as in the case of conventional LED signage modules. Commonly used through-hole type red-green-blue (RGB) LEDs are considered. To demonstrate the design, manufacturing, and mechanical flexibility of the design, a prototype LED signage module with a typical industry standard size of 304 mm × 304 mm × 10 mm was designed and fabricated. Experimental testing and finite element simulations were conducted to analyze mechanical flexibility and internal stresses in the module. The results demonstrate that the new design provides flexible LED modules, without altering the conventional LED control system. It is shown that maximum stress occurs in the spacing between the PCBs and is small even for large module deflection. As the curvature of module deflection was decreased, the maximum stress increased, indicating an important design parameter for the module deflection. The proposed design architecture will enable both indoor and outdoor digital advertising using billboards on a wide range of curved surfaces.
Inferring pore radius and density from ultrasonic attenuation using physics-based modeling
Authors: White R. D. , Yousefian O. , Banks H. T. , Alexanderian A. , Muller M.
Published: January 2021

This work proposes the use of two physics-based models for wave attenuation to infer the microstructure of cortical bone-like structures. One model for ultrasound attenuation in porous media is based on the independent scattering approximation (ISA) and the other model is based on the Waterman Truell (WT) approximation. The microstructural parameters of interest are pore radius and pore density. Attenuation data are simulated for three-dimensional structures mimicking cortical bone using the finite-difference time domain package SimSonic. These simulated structures have fixed sized pores (monodisperse), allowing fine-tuned control of the microstructural parameters. Structures with pore radii ranging from 50 to 100  μm and densities ranging from 20 to 50 pores/mm3 are generated in which only the attenuation due to scattering is considered. From here, an inverse problem is formulated and solved, calibrating the models to the simulated data and producing estimates of pore radius and density. The estimated microstructural parameters closely match the values used to simulate the data, validating the use of both the ISA and WT approximations to model ultrasonic wave attenuation in heterogeneous structures mimicking cortical bone. Furthermore, this illustrates the effectiveness of both models in inferring pore radius and density solely from ultrasonic attenuation data.
Prediction of Upper Respiratory Illness Using Salivary Immunoglobulin A in Youth Athletes
Authors: Sawczuk Thomas , Jones Ben , Welch Mitchell , Beggs Clive , Scantlebury Sean , Till Kevin
Published: January 2021

Purpose: To evaluate the relative importance and predictive ability of salivary immunoglobulin A (s-IgA) measures with regards to upper respiratory illness (URI) in youth athletes. Methods: Over a 38-week period, 22 youth athletes (age = 16.8 [0.5] y) provided daily symptoms of URI and 15 fortnightly passive drool saliva samples, from which s-IgA concentration and secretion rate were measured. Kernel-smoothed bootstrapping generated a balanced data set with simulated data points. The random forest algorithm was used to evaluate the relative importance (RI) and predictive ability of s-IgA concentration and secretion rate with regards to URI symptoms present on the day of saliva sampling (URIday), within 2 weeks of sampling (URI2wk), and within 4 weeks of sampling (URI4wk). Results: The percentage deviation from average healthy s-IgA concentration was the most important feature for URIday (median RI 1.74, interquartile range 1.41–2.07). The average healthy s-IgA secretion rate was the most important feature for URI4wk (median RI 0.94, interquartile range 0.79–1.13). No feature was clearly more important than any other when URI symptoms were identified within 2 weeks of sampling. The values for median area under the curve were 0.68, 0.63, and 0.65 for URIday, URI2wk, and URI4wk, respectively. Conclusions: The RI values suggest that the percentage deviation from average healthy s-IgA concentration may be used to evaluate the short-term risk of URI, while the average healthy s-IgA secretion rate may be used to evaluate the long-term risk. However, the results show that neither s-IgA concentration nor secretion rate can be used to accurately predict URI onset within a 4-week window in youth athletes.
Preseason Training Improves Perception of Fatigue and Recovery From a Futsal Training Session
Authors: Wilke Carolina Franco , Wanner Samuel P. , Penna Eduardo M. , Maia-Lima André , Santos Weslley H.M. , Müller-Ribeiro Flávia C. , Mendes Thiago T. , Bruzzi Rubio S. , Ramos Guilherme P. , Nakamura Fábio Y. , Duffield Rob
Published: January 2021

Purpose: To compare the posttraining recovery timeline of elite Brazilian futsal athletes before (Pre-PS) and after 10 weeks of the preseason (Post-PS) period of high-intensity technical–tactical training. Methods: At the start (n = 13) and at the end of the preseason (n = 7), under-20 male futsal players undertook fitness testing for maximal aerobic power, the countermovement jump (CMJ), and the 10-m sprint with change of direction. Furthermore, at both Pre-PS and Post-PS, the players participated in a training session where performance and psychophysiological measures were recorded before, immediately, 3, 24, and 48 hours postsession. The measures included CMJ, 10-m sprint, creatine kinase, Total Quality Recovery Scale, and Brunel Mood Scale. Effect size (ES) analyses compared fitness and posttraining recovery values for each parameter at Pre-PS versus Post-PS. Results: Only trivial ES (−0.02 to 0.11) was evident in maximal aerobic power, CMJ, and 10-m sprint at Post-PS compared with Pre-PS. For the timeline of recovery, only trivial and small ESs were evident for the 10-m sprint (−0.12 to 0.49), though CMJ recovery was improved at 3 hours (0.87) and 48 hours (1.27) at Post-PS and creatine kinase was lower at 48 hours (−1.33) at Post-PS. Perception of recovery was improved in Post-PS at 3 hours (1.50) and 24 hours postsession (0.92). Furthermore, perception of effort was lower immediately after the session (−0.29), fatigue was lower at 3 hours (−0.63), and vigor responses were improved in all postseason assessments (0.59 to 1.13). Conclusion: Despite minimal changes in fitness, preseason training attenuated players’ perception of effort and fatigue and improved their recovery profile following a high-intensity technical–tactical training session.
The intratumoral CXCR3 chemokine system is predictive of chemotherapy response in human bladder cancer
Authors: Vollmer Tino , Schlickeiser Stephan , Amini Leila , Schulenberg Sarah , Wendering Desiree J. , Banday Viqar , Jurisch Anke , Noster Rebecca , Kunkel Desiree , Brindle Nicola R. , Savidis Ioannis , Akyüz Levent , Hecht Jochen , Stervbo Ulrik , Roch Toralf , Babel Nina , Reinke Petra , Winqvist Ola , Sherif Amir , Volk Hans-Dieter , Schmueck-Henneresse Michael
Published: January 2021

Activity of the CXCR3alt-CXCL11 chemokine system in CD8
+
stem-like T cells predicts chemotherapy response in patients with bladder cancer.
Complete Genome Sequence of
Francisella
sp. Strain LA11-2445 (FDC406), a Novel
Francisella
Species Isolated from a Human Skin Lesion
Authors: Öhrman Caroline , Uneklint Ingrid , Karlsson Linda , Respicio-Kingry Laurel , Forsman Mats , Petersen Jeannine M. , Sjödin Andreas
Published: January 2021

Here, we present the 2,139,666-bp circular chromosome of
Francisella
sp. strain LA11-2445 (FDC406), a proposed novel species of
Francisella
that was isolated from a human cutaneous lesion and is related to
Francisella
species from marine environments.
Metagenome-Assembled Genome Sequences of a Biofilm Derived from Marsberg Copper Mine
Authors: Arif Sania , Nacke Heiko , Hoppert Michael
Published: January 2021

We sequenced the metagenome of a biofilm collected near a leachate stream of the Marsberg copper mine (Germany) and reconstructed eight metagenome-assembled genomes. These genomes yield copper resistance through Cu(I) oxidation via multiple copper oxidases and extrusion through copper-exporting P-type ATPases.
Complete Genome Sequence of Neonatal Clinical Group B Streptococcal Isolate CJB111
Authors: Spencer Brady L. , Chatterjee Anushila , Duerkop Breck A. , Baker Carol J. , Doran Kelly S.
Published: January 2021

Group B
Streptococcus
(GBS) is an asymptomatic colonizer of the female reproductive tract but can cause maternal and neonatal infections and adverse pregnancy outcomes. Here, we closed the genome sequence of strain CJB111, a neonatal GBS clinical isolate from a case of late-onset bacteremia without focus (Houston, TX; 1990).
Type II cryoglobulinemic vasculitis in the setting of MALT lymphoma
Authors: Reed Griffin J , Hazim Antonious Z , Sanchez-Alvarez Catalina , Warrington Kenneth J
Published: January 2021

The objectives of this article are to present a case of type II cryoglobulinemic vasculitis, explain why mucosa-associated lymphoid tissue (MALT) lymphoma is an unusual cause of type II cryoglobulins and to discuss the aetiology, epidemiology, pathophysiology and treatment of cryoglobulinemic vasculitis. A 67-year-old woman presented with 4 months of weight loss, intermittent epistaxis and a purpuric skin rash. Prior to presentation, she was found to have an elevated rheumatoid factor. Further investigation revealed an acute kidney injury and elevated type II cryoglobulins suspicious for cryoglobulinemic vasculitis, which was confirmed by kidney biopsy. Additional workup for the weight loss included biopsy of newly found splenomegaly. Pathology revealed MALT lymphoma, a rare cause of type II cryoglobulinemic vasculitis. Successful medical therapy required treating the underlying malignancy with rituximab and high-dose steroids. After initial resolution of symptoms with this regimen, the patient’s vasculitis worsened, which was thought to be secondary to undertreatment of the lymphoma. Bendamustine was added to further treat the lymphoma, after which the patient recovered and was able to discharge without recurrence of symptoms at 6 months.
Paediatric desmoid tumour of the head and neck: a complete response to chemotherapy and the paradigm shift towards non-surgical management
Authors: Proença Filipa , Constantino Claudia , Lemos Maria Manuel , Borges Alexandra
Published: January 2021

Desmoid tumours are rare locally aggressive mesenchymal tumours with a high local recurrence rate, particularly in the head and neck locations. We present the case of a 5-year-old child with a locally invasive inoperable desmoid tumour of the masticator space who underwent a low-dose chemotherapy regimen for 17 months, obtaining a long-term complete response. Definitive evidenced-based treatment guidelines are lacking. Therefore, paediatric patients should be managed by specialised multidisciplinary teams to try to achieve the best tumour control while minimising treatment associated morbidity and mortality. Available treatment options include surgery, radiotherapy and different systemic medical therapies. Whereas traditionally, surgery was the mainstay of treatment, more conservative options have increasingly shown adequate tumour control with little associated morbidity. In this decision making it is mandatory to take into account the patient’s age, tumour location and extension, and potential short-term and long-term treatment-related sequelae to minimise functional and cosmetic compromise.
Management of a prestyloid parapharyngeal first branchial cleft cyst from puncture to surgical excision and how a routine procedure can turn into an emergency
Authors: Fiedler Lukas S
Published: January 2021

The anatomy of the parapharyngeal space (PPS) is complex and the differential diagnosis of tumours in this area broad. Although primary tumours of the PPS account for only 0.5% of head and neck neoplasms and are benign lesions in 80% of the cases, the surgical management is crucial and needs specific planning and evaluation of CT and/or MRI scans. In literature, there are several ways to surgically deal with PPS tumours and due to location and differentiation, can reach from transparotid, submandibular transcervical and transoral approaches, extending in a mandibulotomy, further radiotherapy. Parapharyngeal cleft cysts are extremely rare and their management can be complex. We describe the presentation, the diagnosis and further management of a 71-year-old woman with a 6 cm first branchial cleft cyst in the PPS from puncture over emergency tracheostomy to elective excision via a combined transcervical/transparotid and transoral approach. We highlight the importance of the differential diagnosis and the and the correct clinical management of this rare entity.
Unusual presentation of mucormycosis mimicking a localised sino-orbital pathology
Authors: Dadhich Anuj , Nilesh Kumar , Patil Rahul , Saluja Harish
Published: January 2021

Mucormycosis is an aggressive and deadly fungal infection, which is invariably associated with an immunocompromised patient. Mucormycosis in the head and neck region presents as skeletal necrosis, with or without soft tissue involvement. Early identification and treatment with combination of surgical debridement and parenteral antifungal therapy is critical for a favourable outcome. This paper reports an unusual presentation of mucormycosis, mimicking a localised sino-orbital pathology involving the infraorbital subcutaneous tissue and the maxillary sinus, in a 35 years old immunocompetent man. Despite aggressive antifungal therapy and surgical management, the course of disease was fatal, reiterating the high mortality associated with mucormycosis.
Use of pedicled latissimus dorsi flap in anterior chest wall reconstruction
Authors: Vyas Rini , Rollett Rebecca , Patel Nakul , Rathinam Sridhar
Published: January 2021

Successful surgical management of chest wall tumours relies on extensive chest wall resection with adequate margins. In large complex tumours, return to form and function is determined by appropriate skeletal and soft tissue reconstruction of the chest wall defect. We report an original case of a large 11×16×3 cm ulcerative basosquamous carcinoma of the anterior chest wall. Soft tissue reconstruction was performed with a unilateral pedicled latissimus dorsi flap. A multidisciplinary approach between thoracic and plastic surgeons was used in the planning, intraoperative and follow-up periods. This case highlights a good long-term functional and cosmetic outcome in complex chest wall reconstruction as a result of successful cross-specialty collaboration.
One-year intensive lifestyle intervention and improvements in health-related quality of life and mental health in persons with type 2 diabetes: a secondary analysis of the U-TURN randomized controlled trial
Authors: MacDonald Christopher Scott , Nielsen Sabrina M , Bjørner Jakob , Johansen Mette Y , Christensen Robin , Vaag Allan , Lieberman Daniel E , Pedersen Bente Klarlund , Langberg Henning , Ried-Larsen Mathias , Midtgaard Julie
Published: January 2021

Introduction

The effects of lifestyle interventions in persons with type 2 diabetes (T2D) on health-related quality of life (HRQoL) and subjective well-being are ambiguous, and no studies have explored the effect of exercise interventions that meet or exceed current recommended exercise levels. We investigated whether a 1-year intensive lifestyle intervention is superior in improving HRQoL compared with standard care in T2D persons.

Research design and methods

We performed secondary analyses of a previously conducted randomized controlled trial (April 2015 to August 2016). Persons with non-insulin-dependent T2D (duration ≤10 years) were randomized to 1-year supervised exercise and individualized dietary counseling (ie, ‘U-TURN’), or standard care. The primary HRQoL outcome was change in the 36-item Short Form Health Survey (SF-36) physical component score (PCS) from baseline to 12 months of follow-up, and a key secondary outcome was changes in the SF-36 mental component score (MCS).

Results

We included 98 participants (U-TURN group=64, standard care group=34) with a mean age of 54.6 years (SD 8.9). Between-group analyses at 12-month follow-up showed SF-36 PCS change of 0.8 (95% CI −0.7 to 2.3) in the U-TURN group and deterioration of 2.4 (95% CI −4.6 to −0.1) in the standard care group (difference of 3.2, 95% CI 0.5 to 5.9, p=0.02) while no changes were detected in SF-36 MCS. At 12 months, 19 participants (30%) in the U-TURN group and 6 participants (18%) in the standard care group achieved clinically significant improvement in SF-36 PCS score (adjusted risk ratio 2.6, 95% CI 1.0 to 4.5 corresponding to number needed to treat of 4, 95% CI 1.6 to infinite).

Conclusion

In persons with T2D diagnosed for less than 10 years, intensive lifestyle intervention improved the physical component of HRQoL, but not the mental component of HRQoL after 1 year, compared with standard care.

Trial registration number

NCT02417012.
Associations of active travel with adiposity among children and socioeconomic differentials: a longitudinal study
Authors: Laverty Anthony A , Hone Thomas , Goodman Anna , Kelly Yvonne , Millett Christopher
Published: January 2021

Objectives

Examine longitudinal associations between modes of travel to school and adiposity.

Setting

The UK.

Participants

8432 children surveyed at ages 7, 11 and 14 years from the UK Millennium Cohort Study.

Primary and secondary outcomes

Objective percentage body fat and body mass index (BMI). Transport mode was categorised as private motorised transport, public transport and active transport (walking or cycling). Socioeconomic position (SEP) was measured by household income group and occupational social class. We adjusted analyses for changes in the country of UK, frequency of eating breakfast, self-reported growth spurts, hours of screen time and days per week of moderate-to-vigorous physical activity. Longitudinal (panel) regression models adjusting for individual fixed effects examined associations in changes in mode of travel to school and adiposity, controlling for both time-varying and time-invariant potential confounders. Interaction tests and stratified analyses investigated differences by markers of SEP.

Results

At age 14 years, 26.1% of children (2198) reported using private motorised transport, 35.3% (2979) used public transport and 38.6% (3255) used active transport to get to school. 36.6% (3083) of children changed mode two times between the three waves and 50.7% (4279) changed once. Compared with continuing to use private transport, switching to active transport was associated with a lower BMI (−0.21 kg/m2, 95% CI −0.31 to −0.10) and body fat (−0.55%, 95% CI −0.80% to −0.31%). Switching to public transport was associated with lower percentage body fat (−0.43%, 95% CI −0.75% to −0.12%), but associations with BMI did not reach statistical significance (−0.13 kg/m2, 95% CI −0.26 to 0.01). Interaction tests showed a trend for these effects to be stronger in more deprived groups, but these interactions did not reach statistical significance.

Conclusion

This longitudinal study during a key life course period found switching to physically active forms of travel can have beneficial adiposity impacts; these associations may be more apparent for more disadvantaged children. Increasing active travel has potential to ameliorate inequalities.
Comparing quality of primary healthcare between public and private providers in China: study protocol of a cross-sectional study using unannounced standardised patients in seven provinces of China
Authors: Xu Dong , Pan Jay , Dai Xiaochen , Hu Mengyao , Cai Yiyuan , He Hua , Zhang Yaoguang , Liao Jing , Chen Yaolong , Gong Wenjie , Zhou Zhongliang , Zhang Nan , Wang Xiaohui , Chan Kwun Chuen Gary , YING Xiaohua , Cai Yue , Wang Ruixin , Xue Qingping , Yip Chi-Man (Winnie)
Published: January 2021

Introduction

The Chinese government has encouraged the development of private sector in delivering healthcare, including primary healthcare (PHC) in the new round of national health reform since 2009. However, the debate about the role of the private sector in achieving universal health coverage continues with poor support from theories and empirical evidence. This study intends to compare the quality of PHC services between the private and public providers in seven provinces in China, using unannounced standardised patients (USPs).

Methods

We are developing and validating 13 USP cases most commonly observed in the PHC setting. Six domains of quality will be assessed by the USP: effectiveness, safety, patient centredness, efficiency, timeliness and equity. The USP will make 2200 visits to 705 public and 521 private PHC institutions across seven provinces, following a multistage clustered sample design. Using each USP-provider encounter as the analytical unit, we will first descriptively compare the raw differences in quality between the private and public providers and then analyse the association of ownership types and quality, using propensity score weighting.

Ethics and dissemination

The study was primarily funded by the National Natural Science Foundation of China (#71974211, #71874116 and # 72074163) and was also supported by the China Medical Board (#16-260, #18-300 and #18-301), and have received ethical approval from Sun Yat-sen University (#2019–024). The validated USP tool and the data collected in this study will be freely available for the public after the primary analysis of the study.

Trial registration number

Chinese Clinical Trial Registry: #ChiCTR2000032773.
Comparing the cumulative live birth rate of cleavage-stage versus blastocyst-stage embryo transfers between IVF cycles: a study protocol for a multicentre randomised controlled superiority trial (the ToF trial)
Authors: Cornelisse Simone , Ramos Liliana , Arends Brigitte , Brink-van der Vlugt Janneke J , de Bruin Jan Peter , Curfs Max HJN , Derhaag Josien , van Dongen Angelique , van Echten-Arends Jannie , Groenewoud Eva R , Maas Jacques WM , Pieterse Quirine , van Santbrink Evert JP , Slappendel Els , Traas Maaike AF , Visser Jantien , Vergouw Carlijn G , Verhoeve Harold R , van der Westerlaken Lucette AJ , Wurth Yvonne , van der Zanden Moniek , Braat Didi DM , van Wely Madelon , Mastenbroek Sebastiaan , Fleischer Kathrin
Published: January 2021

Introduction

In vitro fertilisation (IVF) has evolved as an intervention of choice to help couples with infertility to conceive. In the last decade, a strategy change in the day of embryo transfer has been developed. Many IVF centres choose nowadays to transfer at later stages of embryo development, for example, transferring embryos at blastocyst stage instead of cleavage stage. However, it still is not known which embryo transfer policy in IVF is more efficient in terms of cumulative live birth rate (cLBR), following a fresh and the subsequent frozen–thawed transfers after one oocyte retrieval. Furthermore, studies reporting on obstetric and neonatal outcomes from both transfer policies are limited.

Methods and analysis

We have set up a multicentre randomised superiority trial in the Netherlands, named the Three or Fivetrial. We plan to include 1200 women with an indication for IVF with at least four embryos available on day 2 after the oocyte retrieval. Women are randomly allocated to either (1) control group: embryo transfer on day 3 and cryopreservation of supernumerary good-quality embryos on day 3 or 4, or (2) intervention group: embryo transfer on day 5 and cryopreservation of supernumerary good-quality embryos on day 5 or 6. The primary outcome is the cLBR per oocyte retrieval. Secondary outcomes include LBR following fresh transfer, multiple pregnancy rate and time until pregnancy leading a live birth. We will also assess the obstetric and neonatal outcomes, costs and patients’ treatment burden.

Ethics and dissemination

The study protocol has been approved by the Central Committee on Research involving Human Subjects in the Netherlands in June 2018 (CCMO NL 64060.000.18). The results of this trial will be submitted for publication in international peer-reviewed and in open access journals.

Trial registration number

Netherlands Trial Register (NL 6857).
Examining the impacts of the COVID-19 pandemic on family mental health in Canada: findings from a national cross-sectional study
Authors: Gadermann Anne C , Thomson Kimberly C , Richardson Chris G , Gagné Monique , McAuliffe Corey , Hirani Saima , Jenkins Emily
Published: January 2021

Objectives

In the first wave of the COVID-19 pandemic, social isolation, school/child care closures and employment instability have created unprecedented conditions for families raising children at home. This study describes the mental health impacts of the COVID-19 pandemic on families with children in Canada.

Design, setting and participants

This descriptive study used a nationally representative, cross-sectional survey of adults living in Canada (n=3000) to examine the mental health impacts of the COVID-19 pandemic. Outcomes among parents with children <18 years old living at home (n=618) were compared with the rest of the sample. Data were collected via an online survey between 14 May to 29 May 2020.

Outcome measures

Participants reported on changes to their mental health since the onset of the pandemic and sources of stress, emotional responses, substance use patterns and suicidality/self-harm. Additionally, parents identified changes in their interactions with their children, impacts on their children’s mental health and sources of support accessed.

Results

44.3% of parents with children <18 years living at home reported worse mental health as a result of the COVID-19 pandemic compared with 35.6% of respondents without children <18 living at home, χ2 (1, n=3000)=16.2, p<0.001. More parents compared with the rest of the sample reported increased alcohol consumption (27.7% vs 16.1%, χ2 (1, n=3000)=43.8, p<0.001), suicidal thoughts/feelings (8.3% vs 5.2%, χ2 (1, n=3000)=8.0, p=0.005) and stress about being safe from physical/emotional domestic violence (11.5% vs 7.9%, χ2 (1, n=3000)=8.1, p=0.005). 24.8% (95% CI 21.4 to 28.4) of parents reported their children’s mental health had worsened since the pandemic. Parents also reported more frequent negative as well as positive interactions with their children due to the pandemic (eg, more conflicts, 22.2% (95% CI 19.0 to 25.7); increased feelings of closeness, 49.7% (95% CI 45.7 to 53.7)).

Conclusions

This study identifies that families with children <18 at home have experienced deteriorated mental health due to the pandemic. Population-level responses are required to adequately respond to families’ diverse needs and mitigate the potential for widening health and social inequities for parents and children.