bluuebunny/crossref_metadata_2025 huggingface dataset:
Determinants associated with doctors’ prescribing behaviors in public hospitals in China
Authors: Pan Lihua , Zhao Ran , Zhao Nan , Wei Liangmin , Wu Yanling , Fan Hong
Published: September 2021

Doctors’ prescribing behaviors impact both medical expenses and health resources. This study aims to identify the significant determinants of prescribing behaviors of doctors, which could potentially provide theoretical evidence on how to improve prescribing decisions. A multistage, stratified, cluster, random sampling method was employed in this survey. Data were collected from Jiangsu and Shanxi provinces in China in 2018. A total of 444 doctors in public hospitals completed the self‐administered questionnaires. A structural equation model based on the theory of planned behavior (TPB) was adopted for analysis. On the basis of the TPB, we constructed a model of doctors’ prescribing behaviors, which explained the subjective and objective reasons for irrational prescribing behavior. Behavioral attitude, subjective norms, and perceived behavioral control could positively influence the actual behaviors, of which subjective norms impact prescribing behaviors the most. Employing the TPB helped in identifying determinants of prescribing behaviors from a new perspective. More significant policy changes and government support are required to help improve appropriate prescribing behaviors and ultimately make better prescribing decisions. This study provided a deeper understanding of this complex issue and will inform the development of a theory and evidence‐based intervention for future research.
Impact of missing outcome data in meta‐analyses of lifestyle interventions during pregnancy to reduce postpartum weight retention: An overview of systematic reviews with meta‐analyses and additional sensitivity analyses
Authors: Harris Rebecca G. , Batterham Marijka , Neale Elizabeth P. , Ferreira Isabel
Published: September 2021

High risk of bias associated with missing outcome data (MOD) in meta‐analyses (MAs) of the effects of lifestyle interventions during pregnancy on postpartum weight retention (PPWR) casts doubt on whether such interventions can be relied upon as truly effective. This systematic overview of three MAs (19 RCTs), each with high MOD rates in the subset of RCTs included, examined how MOD were addressed in the estimation of summary intervention effects. All MAs reported beneficial and statistically significant intervention effects estimated based on complete case analyses, deemed valid if MOD was missing at random (MAR). Therefore, we conducted sensitivity analyses using pattern mixture models and informative missingness parameters (describing how the outcome in the missing participants may be related to the outcome in the completers), to ascertain the robustness of the estimates to reasonable deviations from the MAR assumption. In plausible scenarios where the response in intervention group participants with versus without MOD was worse (by just 0.5 kg), effect estimates were attenuated in all MAs and no longer statistically significant in two MAs. Statistical significance was retained when all 19 RCTs identified across MAs were examined together in a broader meta‐analysis: −0.63 kg (95%CI −0.17, −0.08), but the clinical relevancy of effects of this magnitude remains unclear.
Methyltransferase‐like 3‐induced N6‐methyladenosine upregulation promotes oral squamous cell carcinoma by through p38
Authors: Xu Ting , Zhang Wenbo , Chai Li , Liu Chao , Zhang Shizhou , Xu Tong
Published: September 2021

Background

Oral squamous cell carcinoma (OSCC), a main type of squamous cell cancer, is associated with considerable morbidity and mortality. Recent reports suggested methyltransferase‐like 3 (METTL3)‐mediated N6‐methyladenosine (m6A) modification to be an essential regulator in the fate determination of stem cells. However, the functional significance of METTL3 in OSCC remains largely unknown.

Methods

METTL3 expression was examined in OSCC patient samples, followed by correlation analysis against clinical tumor features. Functional assays, such as assessment of surface marker expression, colony forming, BrdU incorporation, tumor xenograft assay, and m6A dot blot, were conducted to study the impact of METTL3 knockdown (KD) in OSCC cells.

Results

High METTL3 expression was positively correlated with more severe clinical features of OSCC tumors. METTL3 KD caused impairment of stem‐like capacities in OSCC cells, such as tumorigenicity in vivo and colony‐forming ability in vitro. Furthermore, METTL3‐KD and cycloleucine, a methylation inhibitor, decreased m6A levels and down‐regulated p38 expression in OSCC cells. On the contrary, the impaired cell proliferation capacity of OSCC cells after METTL3‐KD was restored by exogenous expression of p38.

Conclusion

Our findings identified m6A methyltransferase METTL3 as a key element in the regulation of tumorigenesis in OSCC.
The Effect of Marketing Breadth and Competitive Spread on Category Growth
Authors: Xiang Yi , Soberman David , Gatignon Hubert
Published: September 2021

Understanding the patterns of demand evolution for a new category is important for firms to effectively manage capacity planning, market and service operations, and research and development. Our objective is to analyze how marketing at the industry level affects the evolution of primary demand in different stages of the product life cycle. We characterize the aggregate marketing activities in two constructs: marketing breadth and competitive spread. The first construct reflects the spread of spending across different marketing instruments at the industry level, and the second construct reflects the spread of spending across different firms. Though both constructs are related to the spread of spending within a category, we find that they have qualitatively different effects on category growth. An econometric model making use of the hierarchical nature of time observations within countries is estimated for each category. First, we find that high degrees of spending breadth impede market growth when the number of competitors is small (the category is young) but accelerate market growth when the number of competitors is higher (the category is maturing). Second, we find that high levels of competitive spread decrease category growth when spending levels are relatively low. However, as spending levels increase, the negative effect of competitive spread on demand growth all but evaporates.
Seeing the forest for the trees: Use of phages to treat bacterial tree diseases
Authors: Grace Emily R. , Rabiey Mojgan , Friman Ville‐Petri , Jackson Robert W.
Published: September 2021

Trees and woody plants can be attacked by many pests and pathogens either individually or as polymicrobial infections. In particular, infections caused by tree‐specific bacterial pathogens have become more common during the last decade, causing serious concern for important tree and woody plant species in horticulture, urban environments, and forests. For example, Xylella and Pseudomonas bacteria are causing significant economic and ecological devastation throughout Europe in olive, cherry, and other stone fruits, mainly because of lack of efficient control methods and the emergence of bacterial resistance to traditional antimicrobial compounds such as copper and antibiotics. Hence, there is an urgent need for innovative approaches to tackle bacterial plant diseases. One way to achieve this could be through the application of biological control, which offers a more environmentally friendly and targeted approach for pathogen management. This review will explore recent advances in use of pathogen‐specific viruses, bacteriophages (or phages), for the biocontrol of bacterial tree diseases. Phages are an important component of plant microbiomes and are increasingly studied in plant pathogen control due to their highly specific host ranges and ability to selectively kill only the target pathogenic bacteria. However, their use still poses several challenges and limitations, especially in terms of managing the bacterial diseases of long‐lived trees. A particular insight will be given into phage research focusing on controlling Pseudomonas syringae pathovars, Erwinia amylovora, Xanthomonas species, Ralstonia solanacearum, and Agrobacterium tumefaciens. Recent milestones, current challenges, and future avenues for phage therapy in the management of tree diseases are discussed.
The Advocacy Coalition Index: A new approach for identifying advocacy coalitions
Authors: Satoh Keiichi , Gronow Antti , Ylä‐Anttila Tuomas
Published: September 2021

Policy scholars have increasingly focused on collaborative and competitive relationships between stakeholder coalitions. The Advocacy Coalition Framework (ACF) in particular has directed scholarly attention toward such relationships. The ACF defines advocacy coalitions as groups of actors who share beliefs and coordinate their action. However, previous research has been inconsistent in defining and measuring coalitions, which has hampered comparative research and theory building. We present a method called the Advocacy Coalition Index, which measures belief similarity and the coordination of action in a manner that makes it possible to assess the extent to which advocacy coalitions are found in policy subsystems, whether subgroups resemble coalitions, and how individual actors contribute to coalition formation. The index provides a standardized method for identifying coalitions that can be applied to comparative research. To illustrate the effectiveness of the index, we analyze two climate change policy subsystems, namely Finland and Sweden, which have been shown to differ in terms of the association of belief similarity with coordination. We demonstrate that the index performs well in identifying the different types of subsystems, coalitions, and actors that contribute the most to coalition formation, as well as those involved in cross‐coalition brokerage.
Pioneer herbaceous plants contribute to the restoration of pollination interactions in restinga habitats in tropical Atlantic Forest
Authors: Deprá Mariana Scaramussa , Evans Darren Mark , Gaglianone Maria Cristina
Published: September 2021

The Brazilian Atlantic Forest is one of the most endangered biodiversity hotspots in the world and restinga ecosystems are exposed to intense degradation. The restoration of these ecosystems is challenging as there is a lack of understanding, among other aspects, of how plants interact with pollinators. Ecological networks are useful for assessing restoration outcomes as they provide data on the reestablishment of interactions. Here, we evaluated the restoration success of pollination interactions in a restinga in Brazil, by comparing structure, complexity, and robustness of plant–flower visitor networks in newly planted sites (restoration) with target reference sites (control). In the restoration area, more species and interactions were recorded (120 insect species, 25 plant species, and 1,361 interactions) compared to the control area (74, 19, and 471, respectively), mainly due to the high abundance of common insect species. The majority of the interactions in restoration sites (81.1%) occurred with naturally arriving pioneers (68% of plant species visited). While network robustness was significantly higher in restoration sites, as a result of a high number of generalist species, interaction evenness was significantly lower, indicating less uniformity in interaction frequencies compared to control sites. Interaction turnover was high, driven by differences in the composition of plants and insects between sites. Our results demonstrate that pollinating insects do reestablish interactions with herbaceous species, enabling their interaction with later flowering target plants in the most advanced stages of restoration. These results should be taken into consideration when proposing measures to attract and retain pollinators in areas under restoration.
Global and Transnational in Form, Soviet in Content: The Changing Semantics of Internationalism in Official Soviet Discourse, 1917–1991
Authors: BRANDENBERGER DAVID
Published: September 2021

The term “internationalism” underwent a series of dramatic, semantic transformations in the USSR between 1917 and 1991. This article offers a Begriffsgeschichte‐style analysis of the conceptual history of the term, tracking its usage in the official press over the course of the Soviet Union's existence. Such a broad, systematic survey indicates that internationalism was used with considerable rigor in official messaging as it was invoked over and over again in the context of ideological formulas and sloganeering. More importantly, this study reveals the connotations of the term to have varied significantly over time for reasons linked chiefly to changes in policymaking priorities. Such findings challenge longstanding assumptions about the static nature of Soviet internationalism, the stability of the so‐called “official line” and the nature of the relationship between ideology and practice in the USSR. Ultimately, this analysis suggests that over the 74‐year lifecycle of the term, internationalism exchanged its revolutionary, antiestablishment semantics for something much more conventional and Soviet‐specific.
Schemas, Interactions, and Objects in Meaning‐Making1
Authors: Rawlings Craig M. , Childress Clayton
Published: September 2021

Sociologists agree that there is something cultural that exists within individuals, in interactions, and in objects. And yet the process through which the culture inside individuals interacts with the culture outside of them is only partially understood and is generally untested. Relying on a novel quasi‐experimental design, we investigate how the culture within individuals, interactions, and objects operates in the making of shared meanings. First, we find that cultural schemas set a baseline for shared meanings of objects. Second, we find that shared meanings are also made through interactions, and more vociferously between individuals with shared schemas. Third, we find that objects encoded with meanings set a higher baseline in interpretive clarity than more ambiguous objects. Lastly, we find that schema similarity and interactions jointly lead to greater shared meanings for more ambiguous objects, suggesting that individuals within groups work rapidly toward generating institutionalized and objectified meanings for objects when those assigned meanings do not yet exist. Findings begin to uncover the routine mechanisms of shared meaning creation, pointing toward new empirical frontiers in culture and cognition.
Opening Pandora's box: molecular phylogeny of the stink bugs (Hemiptera: Heteroptera: Pentatomidae) reveals great incongruences in the current classification
Authors: Roca‐Cusachs Marcos , Schwertner Cristiano F. , Kim Junggon , Eger Joe , Grazia Jocelia , Jung Sunghoon
Published: September 2021

Pentatomidae is one of the largest families within the Heteroptera and contains many species of economic importance, either by being plant pests or by their usefulness as biological control agents. The family is subdivided into as many as ten subfamilies; however, the monophyly of this taxon and phylogenetic relationships within the family have remained unstudied. In this paper, molecular data from mitochondrial [COI (564 bp), 16S RNA (592 bp)] and nuclear genes [28S RNA (646 bp), 18S RNA (1759 bp)] concatenated into a single matrix of 3589 bp, with a sampling of 160 taxa, were used to test the monophyly of the family and relationships based on Maximum Likelihood (ML) and Bayesian Inference (BI) analyses. Both approaches yielded very similar topologies. The most striking result recovered in both analyses is the rejection of the monophyly of Pentatomidae as currently recognized, since Cyrtocorinae do not show a sister relationship with the clade composed of (Serbana + Pentatomidae sensu stricto) in any of the analyses. We corroborate Serbaninae as the sister lineage to all remaining Pentatomidae sensu stricto, and not as a member of Phloeidae as previously hypothesized. The monophyly of Podopinae and Pentatominae, and some of their respective tribes, is rejected. We discuss the current classification of this family and highlight the necessity of a reinterpretation based on the results herein obtained pointing out some of their morphological features. Additionally, cyrtocorids are defined as an independent lineage and upgraded to Cyrtocoridae stat. rev.
The trans‐SNARE complex VAMP4/Stx6/Stx7/Vti1b is a key regulator of Golgi to late endosome MT1‐MMP transport in macrophages
Authors: West Zoe Elizabeth , Aitcheson Savannah Margaret , Semmler Annalese Barbara Trudy , Murray Rachael Zoe
Published: September 2021

The activity of the matrix metalloproteinase (MMP) MT1‐MMP is strictly regulated by expression and cellular location. In macrophages LPS activation leads to the up‐regulation of MT1‐MMP and this need to be at the cell surface for them to degrade the dense extracellular matrix (ECM) components to create a path to migrate into injured and infected tissues. Fixed and live imaging shows newly made MT1‐MMP is packaged into vesicles that traffic to and fuse with LBPA+LAMP1+ late endosomes en route to the surface. The R‐SNARE VAMP4, found on Golgi‐derived vesicles that traffic to late endosomes, forms a trans‐SNARE complex with the Q‐SNARE complex Stx6/Stx7/Vti1b. The Stx6/Stx7/Vti1b complex has been shown to be up‐regulated in lipopolysaccharide (LPS)‐activated cells to increase trafficking of key cytokines through the classical pathway and now we show here it is up‐regulation also plays a role in the late endosomal pathway of MT1‐MMP trafficking. Depletion of any of the SNAREs in this complex reduces surface MT1‐MMP and gelatin degradation. Conversely, overexpression of the Stx6/Stx7/Vti1b components increases surface MT1‐MMP levels. This suggests that Stx6/Stx7/Vti1b is a key Q‐SNARE complex in macrophages during an immune response and in partnership with VAMP4 it regulates transport of newly made MT1‐MMP.
The exports of higher education services from OECD countries to Asian countries: A gravity approach
Authors: Beghin John , Park Byungyul
Published: September 2021

We analyse bilateral exports of higher education services between OECD countries and Asia, using a gravity equation approach, panel data from 1998 to 2016 and PPML regression. The approach treats higher education consumption by Asian countries as a consumable durable good reflecting investment in human capital. Asian students come to OECD countries to obtain degrees from their universities. Structurally, the flow of students from Asian country j to OECD country i depends on the higher education capacity of i, the perceived quality of universities in i, expected earnings in i, a series of bilateral transaction costs between i and j, the income per capita in j, school‐age demographics in j and the usual multilateral trade resistance terms. We find that bilateral flows of students are strongly influenced by wage levels in the host country, bilateral distance, importers’ income, demographics, common language, the visa regime prevailing in bilateral country pairs and the network of migrants from j in i. These results hold through a variation of specifications, proxies and estimation methods. We find mixed evidence on the role of tertiary education capacity in OECD countries and no evidence of a country's university reputations explaining the flow of students. The evolution over time of education capacity, earnings, visa regimes, migrant networks, strong income growth and changes in demographics in nearby export markets explain the emergence of Australia, Canada, Korea and New Zealand and the loss of market share by the US, which still strongly dominates international trade in higher education services. The decline in Chinese students coming to the US is also predicted for the most recent years driven by the reduction in its college‐age population.
The Role of Financial Globalization through FDI in Driving Inequality in the Sub-Saharan Region
Authors: AYENAGBO Kossi
Published: September 2021

This paper examines the relationship between globalization and income inequality in Sub-Saharan Africa (SSA). Globalization is here measured using trade variables like the openness rate (TO), financial variables including FDI while income inequality is measured by the GINI coefficient. This was achieved by using data from 26 countries over the period 2005-2014, using the System Generalized Method of Moments (SGMM) estimator to obtain results from the African context. The results suggested that trade openness exerted an equalizing effect while financial globalization through FDI has been the critical factor driving inequality in the SSA since 2005. The results also showed that outside of FDI, corruption contributes greatly to widening inequality by about 3%. The effect of the other control variables was all together insignificant. The prevailing economic status as portrayed following on the back of the 2008 financial crisis has led to an increase in inequalities in SSA countries. These results are robust to the using of the KOF Globalization index. Through this research, governments and policymakers have to introduce robust and appropriate policies and interventions in their drive for economic growth to decisively deal with corruption and so direct FDI to economically sound targeted priority programs.
Do Cognitive Behavioral Therapy Techniques Reduce Symptom Duration in Children and Adolescents Who Have Sustained a Mild Traumatic Brain Injury?
Authors: Elmer Carlie K. , Valovich McLeod Tamara C.
Published: September 2021

Focused Clinical Question: Does cognitive behavioral therapy (CBT) reduce concussion symptoms among children and adolescents following mild traumatic brain injury? Clinical Bottom Line: Based on the results of this critically appraised topic, there is moderate evidence to support the use of CBT as a treatment intervention to reduce complaints of persistent concussion symptoms in children and adolescents.
The Utilization of the Theory of Planned Behavior and Self-Determination Theory to Improve Physical Activity Following Anterior Cruciate Ligament Reconstruction
Authors: Kleis Rachel R. , Hoch Matthew C. , Dlugonski Deirdre , Hoch Johanna M.
Published: September 2021

Patients with a history of anterior cruciate ligament reconstruction (ACLR) report decreased levels of physical activity participation, which can result in a significant public health burden. Psychosocial factors, such as fear of reinjury and decreased self-efficacy, negatively impact physical activity levels in this population. However, factors such as attitudes and beliefs toward exercise, motivation, self-efficacy, and social support are known to positively influence physical activity participation. The Theory of Planned Behavior (TPB) and Self-Determination Theory (SDT) incorporate such constructs and have been utilized to predict and improve physical activity behaviors in a variety of populations. Emerging evidence has applied the TPB and SDT to rehabilitation adherence in populations with musculoskeletal injury and post-ACLR. However, we believe a combination of the TPB and SDT will provide a framework for increasing physical activity engagement for people with a history of ACLR. The purpose of this review is to present an integrated theoretical model that combines the TPB and SDT with the aim of increasing physical activity after ACLR. Recommendations for future research and clinical practice based on the proposed model are also discussed.
The gendered nature of authorship
Authors: Ni Chaoqun , Smith Elise , Yuan Haimiao , Larivière Vincent , Sugimoto Cassidy R.
Published: September 2021

Authorship is rife with injustice and malpractice, with women expressing concerns about the fair attribution of credit.
Revealing extreme twin-boundary shear deformability in metallic nanocrystals
Authors: Zhu Qi , Kong Lingyi , Lu Haiming , Huang Qishan , Chen Yingbin , Liu Yue , Yang Wei , Zhang Ze , Sansoz Frederic , Zhou Haofei , Wang Jiangwei
Published: September 2021

Twinned nanocrystals exhibit approximately 364% shear strain via extensive twin boundary sliding.
Dynamics of sex chromosome evolution in a rapid radiation of cichlid fishes
Authors: El Taher Athimed , Ronco Fabrizia , Matschiner Michael , Salzburger Walter , Böhne Astrid
Published: September 2021

We show that sex chromosome changes are very frequent in Lake Tanganyika cichlids and repeatedly involve the same chromosomes.
Scaling up fact-checking using the wisdom of crowds
Authors: Allen Jennifer , Arechar Antonio A. , Pennycook Gordon , Rand David G.
Published: September 2021

When rating articles’ accuracy, a small politically balanced crowd of laypeople yields high agreement with fact-checkers.
De novo design of peptides that coassemble into β sheet–based nanofibrils
Authors: Xiao Xingqing , Wang Yiming , Seroski Dillon T. , Wong Kong M. , Liu Renjie , Paravastu Anant K. , Hudalla Gregory A. , Hall Carol K.
Published: September 2021

Computational discoveries and experimental characterizations of coassembly peptides that form β sheet–based nanofibrils.
Three-dimensional perovskite nanowire array–based ultrafast resistive RAM with ultralong data retention
Authors: Zhang Yuting , Poddar Swapnadeep , Huang He , Gu Leilei , Zhang Qianpeng , Zhou Yu , Yan Shuai , Zhang Sifan , Song Zhitang , Huang Baoling , Shen Guozhen , Fan Zhiyong
Published: September 2021

Stable high-density perovskite nanowire array Re-RAMs report unprecedented long retention time and fast switching speed.
Ultrafast pore-loop dynamics in a AAA+ machine point to a Brownian-ratchet mechanism for protein translocation
Authors: Mazal Hisham , Iljina Marija , Riven Inbal , Haran Gilad
Published: September 2021

The pore-loop dynamics of the disaggregation machine ClpB are directly probed, pointing to a Brownian-ratchet mechanism of action.
Intense overpressurization at basaltic open-conduit volcanoes as inferred by geochemical signals: The case of the Mt. Etna December 2018 eruption
Authors: Paonita Antonio , Liuzzo Marco , Salerno Giuseppe , Federico Cinzia , Bonfanti Piero , Caracausi Antonio , Giuffrida Giovanni , La Spina Alessandro , Caltabiano Tommaso , Gurrieri Sergio , Giudice Gaetano
Published: September 2021

Magmatic fluids entering Mt. Etna volcano system from depth exceed those outgassed into atmosphere during inter-eruptive phases.
Cell-free DNA TAPS provides multimodal information for early cancer detection
Authors: Siejka-Zielińska Paulina , Cheng Jingfei , Jackson Felix , Liu Yibin , Soonawalla Zahir , Reddy Srikanth , Silva Michael , Puta Luminita , McCain Misti Vanette , Culver Emma L. , Bekkali Noor , Schuster-Böckler Benjamin , Palamara Pier Francesco , Mann Derek , Reeves Helen , Barnes Eleanor , Sivakumar Shivan , Song Chun-Xiao
Published: September 2021

Novel cell-free DNA whole-genome methylome sequencing method enables accurate cancer detection.
Rare genetic variability in human drug target genes modulates drug response and can guide precision medicine
Authors: Zhou Yitian , Arribas Gabriel Herras , Turku Ainoleena , Jürgenson Tuuli , Mkrtchian Souren , Krebs Kristi , Wang Yi , Svobodova Barbora , Milani Lili , Schulte Gunnar , Korabecny Jan , Gastaldello Stefano , Lauschke Volker M.
Published: September 2021

Rare genetic variants in human drug targets affect drug efficacy and can guide personalized drug selection and drug development.
Child growth and neurodevelopment after maternal antenatal antibiotic treatment
Authors: Videman Karoliina , Hallamaa Lotta , Heimonen Otto , Mangani Charles , Luntamo Mari , Maleta Kenneth , Ashorn Per , Ashorn Ulla
Published: September 2021

Objective

To assess whether intermittent preventive treatment of pregnant women (IPTp) with sulfadoxine-pyrimethamine (SP) and azithromycin (AZI) in a malaria-endemic area leads to sustained gains in linear growth and development in their offspring.

Design

Follow-up study of a randomised trial.

Setting

Mangochi District in rural southern Malawi.

Participants

1320 pregnant women and their offspring.

Interventions

IPTp monthly with SP and twice with AZI (AZI-SP group), monthly with SP but no AZI (monthly SP), or twice with SP (control). No intervention was given to children.

Main outcome measures

Cognitive performance using Raven’s Coloured Progressive Matrices (CPM) at 13 years of age; mean height and height-for-age Z-score (HAZ), cumulative incidence and prevalence of stunting (HAZ <−2); weight, body mass index, mid-upper-arm circumference and head circumference.

Results

At approximately 13 years of age, the mean CPM score was 14.3 (SD 3.8, range 6–29, maximum 36), with no differences between groups. Children in the AZI-SP group were on average 0.4 cm (95% CI −0.9 to 1.7, p=0.6) taller than those in the control group. For cumulative incidence of stunting, the HR in the AZI-SP group was 0.72 (95% CI 0.61 to 0.84, p<0.001) compared with the control and 0.76 (95% CI 0.65 to 0.90, p<0.001) compared with the monthly SP groups. There was no intergroup difference in stunting prevalence or anthropometric measurements.

Conclusions

In rural Malawi, maternal intensified infection control during pregnancy reduces offspring’s cumulative incidence of ever being stunted by 13 years of age. In this study, there was no evidence of a positive impact on cognitive performance.

Trial registration number

NCT00131235.
Temporary atrial overdrive pacing during a drug-refractory electrical storm in acute myocardial infarction
Authors: Chalupová Markéta , Suter Philipp , Graf Denis , Cook Stephane
Published: September 2021

A 64-year-old man with diabetes mellitus was diagnosed with a non-ST-segment elevation myocardial infarction and was treated with stent implantation. Four days later, he developed an electrical storm (ES) that persisted despite antiarrhythmic drugs and sedation. External defibrillation was performed more than 100 times over 2 hours. After ruling out the common causes of polymorphic ventricular tachycardia, an ES was considered because of brady-dependent R-on-T phenomenon, presumably precipitated by antiarrhythmic drugs. Temporary transvenous atrial overdrive pacing allowed complete suppression of premature ventricular complexes and ventricular fibrillation.
Fungal spondylodiscitis: imaging findings and brief review of the literature
Authors: Cevolani Luca , Facchini Giancarlo , Pasini Stefano , Bianchi Giuseppe
Published: September 2021

A 57-year-old man was admitted to our department reporting persistent low back and leg pain; this patient had undergone chemotherapy 1 year earlier for acute myeloid leukaemia (AML). During chemotherapy, he exhibited bilateral pneumonia due toCandida tropicalis, which was treated by specific antibiotic therapy, and septicaemia byEnterococcus faecalis. MRI showed the presence of spondylodiscitis. A CT-guided needle biopsy was performed and the culture from the excised material tested positive forC. tropicalis. We report a rare case of spondylodiscitis byC. tropicalisin a patient treated for AML, which, in turn, was followed by sepsis fromE. faecalisandC. tropicalis. Without adequate treatment, the disease is progressive, and leads to vertebral destruction with secondary kyphosis and neural or spinal cord compression. Although MRI has high sensitivity in the diagnosis of spondylodiscitis, open or needle biopsy allows to identify the aetiology.
Varicella caused by airborne transmission of a localised herpes zoster infection in a family
Authors: Hatsushika Yumi , Nii Isao , Taniguchi Tomohiro
Published: September 2021

Localised herpes zoster infections spread by direct contact with active skin lesion, but airborne transmission is rare. We report a case of varicella from airborne transmission of a localised herpes zoster infection in a family. The patient was a 15-year-old boy who had never been vaccinated against the varicella-zoster virus (VZV). He likely developed varicella from his father, whom the patient lived with. The patient’s father developed a localised herpes zoster infection 2 weeks prior. The patient’s varicella was hypothesised to be due to VZV spread via airborne transmission from the father’s localised infection. To decrease the number of varicella cases, routine vaccination of children against VZV is essential, and immunisation against VZV in middle-aged and elderly patients is also necessary.
Acute-onset isolated bilateral palatal palsy in an adolescent
Authors: Jaiswal Avinash Shekhar , Kumar Rajeev , Sagar Prem , Kumar Rakesh
Published: September 2021

A 16-year-old patient presented with sudden-onset difficulty in swallowing food especially for liquids with nasal regurgitation and rhinolalia with no history of fever and limb weakness. Examination revealed bilateral palatal palsy with absence of gag reflex. Other neurological examinations were normal. Investigations were done to rule out any known pathology leading to such a presentation. The symptoms were attributed to an idiopathic acute-onset-acquired bilateral palatal palsy, in the absence of any identifiable cause. This is a rare presentation in adolescent age with no case reported in the literature so far in this age group. Medical management was started and patient showed complete improvement within 2 weeks of his symptoms. Early diagnosis and aggressive management of this condition lead to a favourable prognosis.
Saline contrast echocardiography complements cardiac interventions in neonates with transposition of great arteries and abnormal ductus venosus anatomy
Authors: Kotecha Monika Kantilal , Choo Jonathan, Tze Liang , Sundararaghavan Sreekanthan
Published: September 2021

We present a rare case of premature low birthweight neonate with right diaphragmatic hernia and transposition of great vessels requiring balloon atrial septostomy. Congenital diaphragmatic hernia poses a unique challenge to umbilical venous catheterisation. Based on the radiographic position of umbilical vein catheter, umbilical venous cannulation was attempted; however, the catheter could not be navigated to the right atrium. Saline contrast echocardiography was used to delineate the abnormal umbilical and ductus venosus drainage. Eventually, the procedure was successfully completed via the femoral venous approach. We emphasise the importance of defining ductus venosus anatomy and umbilical venous drainage using a simple tool like saline contrast echocardiography before performing catheterisation using the umbilical venous access in such cases.
Erosion of conjunctiva over the suture knot with a leak in an eye with a non-flow restrictive aqueous drainage device
Authors: Divya Dangeti , Jariwala Manan , Senthil Sirisha
Published: September 2021

We report a case of conjunctival erosion due to ligature suture knot exposure following Aurolab aqueous drainage device (AADI) implantation. A 48-year-old man, a known case of primary angle-closure glaucoma, had failed trabeculectomy with mitomycin-C and Ahmed glaucoma valve (AGV) in the right eye. The right eye had a large posterior AGV bleb with hypertropia and limitation of extraocular movement on downward gaze and uncontrolled intraocular pressure (IOP). An inferonasal AADI was performed uneventfully. At the 1-month postoperative visit, a small conjunctival erosion was noted over the ligature (6-0 vicryl) suture knot. However, there was no leak. Two weeks later, there was hypotony and a leak was noted at the site of the absorbed ligature. Immediate surgical repair was performed by re-ligature of the AADI tube with 8-0 vicryl and the ligature knot was placed under the scleral patch graft and the conjunctival defect was sutured. Early intervention helped in successfully healing the conjunctival erosion, reversal of the hypotony and well-controlled IOP. Adequate covering of the entire subconjunctival tube including its ligated part by a patch graft may prevent this complication.
Fulminant varicella hepatitis: a rare but lethal cause of abdominal pain
Authors: Fang Christopher , Wong Junice , Ang Wei Wen
Published: September 2021

An 81-year-old woman with no history of immunocompromise presented with 2 days of upper abdominal pain associated with nausea. On arrival, her physical examination was unremarkable apart from mild epigastric and right hypochondriac tenderness, and laboratory investigations were unremarkable apart from mild thrombocytopenia and transaminitis. A CT scan performed on the day of admission revealed a tiny 0.3 cm stone in the common bile duct, with no upstream dilatation. On day 2 of admission, she developed a vesicular rash and with acutely worsening transaminitis. She deteriorated rapidly and demised from complications of acute liver failure within the next 24 hours. The diagnosis of varicella was confirmed with antibody testing. Fulminant varicella hepatitis is an extremely rare and lethal condition with only a handful of reported cases in the current literature. We aim to share our clinical experience and summarise the salient points from existing case reports.
Progression of keratoconus in children and adolescents
Authors: Meyer Jay J , Gokul Akilesh , Vellara Hans R , McGhee Charles N J
Published: September 2021

Aims

To evaluate the rates of keratoconus progression and associated factors in eyes of children and adolescents.

Methods

Retrospective, cohort study of individuals ≤18 years old at the time of keratoconus diagnosis and with at least 6 months of follow-up. Corneal tomography was performed using an Orbscan tomographer (Bausch & Lomb, Rochester, New York, USA) to determine whether progression occurred. Tomographic progression of keratoconus was defined as a change in any of the investigated parameters (keratometry values, KMAX, maximum anterior or posterior elevation, central pachymetry, thinnest pachymetry) beyond the limits of repeatability.

Results

148 eyes of 106 patients with a mean age of 15.2±2.5 years were studied over a mean follow-up period of 2.9±2.2 years. The overall rate of tomographic progression was 77.0% (114/148 eyes). Eyes that progressed had more advanced disease at presentation with higher anterior curvature (KMAX55.4±6.3 vs 52.2±5.4 dioptres; p<0.01), posterior elevation (108.2±40.9 vs 86.3±35.6 µm; p<0.01) and lower central pachymetry measurements (442.1±56.7 vs 454.4±47.5 µm; p=0.01). Age at presentation, gender, atopy, documented eye rubbing, ethnicity and duration of follow-up were not significantly associated with progression in the multivariate analyses. There was a higher rate of bilateral progression if at least one eye had severe keratoconus (73.9%) compared with no severe keratoconus in either eye (36.8%; p=0.03).

Conclusions

A high rate of progression was identified in keratoconic eyes of children and adolescents. More advanced disease at initial presentation may increase the risk of further keratoconus progression.
Incidence, risk factors, natural history and outcomes of heart failure in patients with Graves’ disease
Authors: Naser Jwan A , Pislaru Sorin , Stan Marius N , Lin Grace
Published: September 2021

Objective

Graves’ disease (GD) can both aggravate pre-existing cardiac disease and cause de novo heart failure (HF), but large-scale studies are lacking. We aimed to investigate the incidence, risk factors and outcomes of incident GD-related HF.

Methods

Patients with GD (2009–2019) were retrospectively included. HF with reduced ejection fraction (HFrEF) was defined by left ventricular ejection fraction <50% and Framingham criteria, while HF with preserved ejection fraction (HFpEF) was defined according to the HFA-PEFF criteria. HF due to ischaemia, valve disorder or other structural heart disease was excluded. Proportional hazards regression was used to analyse risk factors and outcomes.

Results

Of 1371 patients with GD, HF occurred in 74 (5.4%) patients (31 (2.3%) HFrEF; 43 (3.1%) HFpEF). In HFrEF, atrial fibrillation (AF) (HR 10.5 (3.0–37.3), p<0.001) and thyrotropin receptor antibody (TRAb) level (HR 1.05 (1.01–1.09) per unit, p=0.007) were independent risk factors. In HFpEF, the independent risk factors were chronic obstructive pulmonary disease (HR 7.2 (3.5–14.6), p<0.001), older age (HR 1.5 (1.2–2.0) per 10 years, p=0.001), overt hyperthyroidism (HR 6.4 (1.5–27.1), p=0.01), higher body mass index (BMI) (HR 1.07 (1.03–1.10) per unit, p=0.001) and hypertension (HR 3.1 (1.3–7.2), p=0.008). The risk of cardiovascular hospitalisations was higher in both HFrEF (HR 10.3 (5.5–19.4), p<0.001) and HFpEF (HR 6.7 (3.7–12.2), p<0.001). However, only HFrEF was associated with an increased risk of all-cause mortality (HR 5.17 (1.3–19.9), p=0.02) and ventricular tachycardia/fibrillation (HR 64.3 (15.9–259.7), p<0.001).

Conclusion

De novo HF occurs in 5.4% of patients with GD and is associated with increased risk of cardiovascular hospitalisations and mortality. Risk factors include AF, higher TRAb, higher BMI and overt hyperthyroidism.
Gene of the month:STK11
Authors: Zyla Roman E , Hahn Elan , Hodgson Anjelica
Published: September 2021

STK11encodes for the protein liver kinase B1, a serine/threonine kinase which is involved in a number of physiological processes including regulation of cellular metabolism, cell polarity and the DNA damage response. It acts as a tumour suppressor via multiple mechanisms, most classically through AMP-activated protein kinase-mediated inhibition of the mammalian target of rapamycin signalling pathway. Germline loss-of-function mutations inSTK11give rise to Peutz-Jeghers syndrome, which is associated with hamartomatous polyps of the gastrointestinal tract, mucocutaneous pigmentation and a substantially increased lifetime risk of many cancers. In the sporadic setting,STK11mutations are commonly seen in a subset of adenocarcinomas of the lung in addition to a number of other tumours occurring at various sites. Mutations inSTK11have been associated with worse prognoses across a range of malignancies and may be a predictor of poor response to immunotherapy in a subset of lung cancers, though further studies are needed before the presence ofSTK11mutations can be implemented as a routine clinical biomarker.
Investigation of exotic state X(3872) in pp collisions at $$\sqrt{s}=7$$, 13 TeV
Authors: Xu Hong-ge , She Zhi-Lei , Zhou Dai-Mei , Zheng Liang , Kang Xiao-Lin , Chen Gang , Sa Ben-Hao
Published: September 2021

We have used the dynamically constrained phase space coalescence model to study the production of the exotic state X(3872) based on the hadronic final states generated by the parton and hadron cascade model (PACIAE) with $$|y|<1$$

|
y
|
<
1

and $$p_T < 15.5$$

p
T

<
15.5

GeV/c in pp collisions at $$\sqrt{s}=7$$

s

=
7

and 13 TeV, respectively. Here the X(3872) is assumed to consist of bound state $$D\bar{D^*}$$

D

D
∗

¯

, which can form three possible structures for the tetraquark state, the nucleus-like state, and the molecular state. The yields of three different structures X(3872) were predicted. The transverse momentum distribution and the rapidity distribution of three different structures X(3872) are also presented. Sizable difference can be found in the transverse momentum and rapidity distributions for the three different X(3872) structures.
A new stratigraphic framework for the early Neoproterozoic successions of Scotland
Authors: Krabbendam Maarten , Strachan Rob , Prave Tony
Published: September 2021

The circum-North Atlantic region archives three major late-Mesoproterozoic to Neoproterozoic tectonic episodes, the Grenville–Sveconorwegian and Renlandian orogenies followed by rifting and formation of the Iapetus Ocean, and each is bracketed by sedimentary successions that define three megasequences. In this context, we summarize sedimentological and geochronological data and propose a new stratigraphic framework for the iconic Torridonian–Moine successions and related units in Scotland. The Iona, Sleat, Torridon and Morar groups of the Scottish mainland and Inner Hebrides, and the Westing, Sand Voe and Yell Sound groups in Shetland, form the newly named Wester Ross Supergroup. They were deposited
c.
1000–950 Ma within a foreland basin to the Grenville Orogen and, collectively, are in Megasequence 1. Some of these units record Renlandian orogenesis at
c.
960–920 Ma. The newly named Loch Ness Supergroup consists of the Glenfinnan, Loch Eil and Badenoch groups of the Scottish mainland, deposited
c.
900–870 Ma and are assigned to Megasequence 2. These units record Knoydartian orogenesis
c.
820–725 Ma. The regionally extensive Dalradian Supergroup belongs to Megasequence 3; it was deposited
c.
<725–500 Ma and records the opening of the Iapetus Ocean, ultimately leading to deposition of the passive margin Cambrian–Ordovician Ardvreck and Durness groups.
Hydrogeochemical indications of regional flow in the Lower Greensand aquifer of the London Basin
Authors: Darling W. George , Lewis Melinda A.
Published: September 2021

The Lower Greensand (LGS) forms the second most important aquifer in the London Basin but, being largely absent beneath the city itself, has received much less attention than the ubiquitous overlying Chalk aquifer. While the general directions of groundwater flow in the Chalk are well established, there has been much less certainty about flow in the LGS owing to regionally sparse borehole information. This study focuses on two hitherto uncertain aspects of the confined aquifer: the sources of recharge to the west-central London Basin around Slough, and the fate of LGS water where the aquifer thins out on the flank of the London Platform in the Gravesend–Medway–Sheppey area on the southern side of the basin. The application of hydrogeochemical techniques including environmental isotopes indicates that recharge to the Slough area is derived from the northern LGS outcrop, probably supplemented by downward leakage from the Chalk, while upward leakage from the LGS in north Kent is mixing with Chalk water to the extent that some Chalk boreholes on the Isle of Sheppey are abstracting high proportions of water with an LGS fingerprint. In doing so, this study demonstrates the value of re-examining previously published data from a fresh perspective.

Thematic collection:
This article is part of the Hydrogeology of Sandstone collection available at:
https://www.lyellcollection.org/cc/hydrogeology-of-sandstone
Detecting Malicious Switches for a Secure Software-defined Tactile Internet
Authors: Yuan Bin , Lin Chen , Zou Deqing , Yang Laurence Tianruo , Jin Hai
Published: September 2021

The rapid development of the Internet of Things has led to demand for high-speed data transformation. Serving this purpose is the Tactile Internet, which facilitates data transfer in extra-low latency. In particular, a Tactile Internet based on software-defined networking (SDN) has been broadly deployed because of the proven benefits of SDN in flexible and programmable network management. However, the vulnerabilities of SDN also threaten the security of the Tactile Internet. Specifically, an SDN controller relies on the network status (provided by the underlying switches) to make network decisions, e.g., calculating a routing path to deliver data in the Tactile Internet. Hence, the attackers can compromise the switches to jeopardize the SDN and further attack Tactile Internet systems. For example, an attacker can compromise switches to launch distributed denial-of-service attacks to overwhelm the SDN controller, which will disrupt all the applications in the Tactile Internet. In pursuit of a more secure Tactile Internet, the problem of abnormal SDN switches in the Tactile Internet is analyzed in this article, including the cause of abnormal switches and their influences on different network layers. Then we propose an approach that leverages the messages sent by all switches to identify abnormal switches, which adopts a linear structure to store historical messages at a relatively low cost. By mapping each flow message to the flow establishment model, our method can effectively identify malicious SDN switches in the Tactile Internet and thus enhance its security.