bluuebunny/crossref_metadata_2025 huggingface dataset:
Fungicide Mitigates Fusarium Head Blight in Durum Wheat When Applied as Late as the End of Flowering in Western Canada
Authors: Singh Gursahib , Hnatowich Garry , Peng Gary , Kutcher Hadley R.
Published: April 2021

Fusarium head blight (FHB) is one of the most important diseases of durum, spring, and winter wheat in Canada. Growers rely on an integrated strategy to manage the disease, including fungicide application at the current recommendation of early to 50% anthesis (BBCH61–65). This study evaluated the effect of fungicide application timing and seeding rates of durum wheat on FHB. Field trials were carried out from 2016 to 2018 at three locations in Saskatchewan. Eight treatments of the metconazole fungicide Caramba were applied to durum seeded at 75 and 400 seeds m−2. The fungicide treatments consisted of a nontreated check, a treated check, and applications at BBCH59, BBCH61, BBCH65, BBCH69, and BBCH73 and a dual application treatment (BBCH61 followed by BBCH73). FHB index, proportion of Fusarium-damaged kernels (%FDK), deoxynivalenol (DON), grain protein content (GPC, %), and yield were evaluated. Seeding rates influenced all parameters. The high seeding rate had a higher yield and FHB index but lower DON and GPC than did the lower seeding rate. All fungicide treatments resulted in lower FHB index, DON, and %FDK than the nontreated check. Under FHB conducive conditions, all anthesis applications from BBCH61 to BBCH69 had a similar effect on FHB index, %FDK, DON, and yield, whereas in years with low disease severity, the application at BBCH65 had lower FHB index, %FDK, and DON relative to other single applications. The dual application (BBCH61 + 73) treatment resulted in similar FHB index levels, %FDK, and DON content as the BBCH65 application at all site years. Our results indicate that the window of fungicide application can be extended to the end of flowering when FHB risk is high.
COVID-19 and telehealth
Authors: Adelman Deborah S. , Fant Catherine , Summer Georgianne
Published: April 2021

In this second article of a three-part series, we explore how stakeholders can be educated on the use of telehealth technology and telemedicine. We address the need for staff and patient support for the transition to telehealth and offer suggestions to NPs for appropriate presentation and interaction with interdisciplinary teams and patients regarding telehealth.
Understanding the most commonly billed diagnoses in primary care
Authors: Rogers Julia , Eastland Taryn
Published: April 2021

This is a 12-part series on the most commonly billed diagnoses in primary care. The article discusses the pathophysiologic processes of acute pharyngitis as well as the clinical manifestations and treatments and how they are linked to disease pathogenesis.
Risk Factors for Preeclampsia: Results from a Cohort of Over 5000 Pregnancies in Spain
Authors: Cuenca Diana , Rolle Valeria , de Paco Matallana Katy , Valiño Nuria , Revello Rocio , Adiego Begoña , Mendoza Manel , Santacruz Belen , Gil Maria del Mar
Published: April 2021

Objective:

To determine the incidence of preeclampsia (PE) and preterm PE in Spain and to identify the risk factors for developing the disease.

Methods:

This is a multicenter prospective cohort study performed at six maternity units across Spain. Women with singleton pregnancies attending their first-trimester routine visit at the hospital were offered participation. Maternal and pregnancy characteristics, including mean arterial pressure, as well as ultrasound findings were recorded. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for subsequent development of PE.

Results:

A total of 5868 pregnancies were recruited for this study, including 174 (3.0%) cases of PE, 47 (0.8%) cases of preterm PE and 127 (2.2%) cases of term PE. Median maternal age was 33.9 years (interquartile range: 30.1 to 36.9) and median gestational age at the routine visit was 12.7  weeks (interquartile range: 12.3 to 13.0). However, 293 (5.0%) of the women were on aspirin treatment during pregnancy, likely reducing the true incidence of the disease. As expected, increasing body mass index (P < 0.001), uterine artery pulsatility index (P = 0.011) and mean arterial pressure (P < 0.001), assisted conception (P = 0.013), previous personal (P < 0.001) or family history of PE (P = 0.024) and chronic hypertension (P = 0.001) were identified as independent risk factors for developing subsequent PE during pregnancy. Screening for PE by maternal factors alone leads to a detection rate of 36.8% (64/174) at 10.0% (587/5868) screen positive rate.

Conclusion:

In Spain, 3.0% of singleton pregnancies are complicated by PE and 0.8% require delivery before term due to its severity. Screening of PE by risk factors alone is only able to detect about 40% of total PE at 10% screen-positive rate.
Employment Status in Individuals with Upper-Limb Amputation: A Survey of Current Trends
Authors: Lee Christina , Engdahl Susannah , Riegger Anna , Davis Alicia , Kelly Brian M. , Gates Deanna H.
Published: April 2021

Introduction

After upper-limb amputation, employment opportunities may be limited. Given the dramatic shift in the job market in the United States in the recent years, there is a need to examine the updated employment rates and the types of occupations to which individuals with amputation can return to. In this study, we assessed current employment status for people with upper-limb loss and determined whether these individuals needed to change jobs as a result of limb loss. Second, we examined whether demographic or impairment-specific factors were correlated with employment status or the need to switch jobs.

Materials and methods

Individuals with upper-limb amputation provided personal and employment information in an online survey. We explored the bivariate relationships between employment status and 11 personal factors (e.g., age at amputation, highest education level). Using the significant factors from this analysis, we built a logistic regression model for postamputation employment status. We also explored the relationship between these same 11 factors and the individuals' need to switch jobs after limb loss.

Results

A total of 199 and 160 respondents were deemed eligible for the employment status and job switch analyses, respectively. Of the working-aged respondents, 60.8% (121/199) were employed at the time of survey. Twenty-nine percent (47/160) reported needing to change jobs because of their amputation. Factors negatively associated with employment included having a bilateral amputation, lower education level, older age at amputation, higher pain frequency, and wearing a prosthesis less frequently. Higher education level was the only significant predictor of successful employment in the logistic regression model. There were no significant relationships between any factor and the need to change jobs after amputation.

Conclusions

The results suggest that individuals with upper-limb amputation have a lower employment rate than the national average. Future work should focus on understanding the reasons behind employment challenges in this population.
Hysteroscopic morcellation for removal of persistent placental remnants in the uterine cornu
Authors: Yu Fan , Li Zhimin , Wang Yi , Yue Zhen , Zhong Yuanyue , Zeng Liqin
Published: April 2021

Rationale:

Hysteroscopic morcellation is an alternative approach for the removal of placental remnants, given its advantages of safety, efficiency and good reproductive outcomes. This superiority can be even more obvious for removing persistent placental remnants in the lateral angle of the uterine cavity after repeated dilation and curettage (D&C) of an angular pregnancy, which is rarely reported.

Patient concerns:

Two patients who were both initially misdiagnosed as having missed intrauterine miscarriages underwent repeated suction-assisted D&C procedures and were found to have persistent placental remnants in the lateral angles of the uterine cavity.

Diagnoses:

Ultrasound and hysteroscopy evaluations showed that placental remnants in both cases were in the lateral uterine angles and protruding to the interstitial myometrium around the fallopian tube. We corrected the diagnosis to that of angular pregnancy according to a comprehensive consideration of the ultrasound, hysteroscopy and pathology results.

Interventions:

We performed MyoSure hysteroscopic morcellation for both patients and the placental remnants were removed completely without any complication.

Outcomes:

The patients were both scheduled for a second-look hysteroscopy 1 to 3 months after surgery, which revealed normal morphology of the uterine cavities and tubal ostia. The patients both achieved normal intrauterine pregnancies several months after surgery.

Lessons:

Hysteroscopic morcellation is a good alternative approach for the removal of placental remnants and should be considered in cases in which there might be a high risk of incomplete evacuation or a high risk of uterine perforation, especially in cases of angular pregnancy.
The changing patterns of comorbidities associated with human immunodeficiency virus infection, a longitudinal retrospective cohort study of Medicare patients
Authors: Williams Nick D. , Huser Vojtech , Rhame Frank , Mayer Craig S. , Fung Kin Wah
Published: April 2021

The objective of this paper is to determine the temporal trend of the association of 66 comorbidities with human immunodeficiency virus (HIV) infection status among Medicare beneficiaries from 2000 through 2016.

We harvested patient level encounter claims from a 17-year long 100% sample of Medicare records. We used the chronic conditions warehouse comorbidity flags to determine HIV infection status and presence of comorbidities. We prepared 1 data set per year for analysis. Our 17 study data sets are retrospective annualized patient level case histories where the comorbidity status reflects if the patient has ever met the comorbidity case definition from the start of the study to the analysis year.

We implemented one logistic binary regression model per study year to discover the maximum likelihood estimate (MLE) of a comorbidity belonging to our binary classes of HIV+ or HIV– study populations. We report MLE and odds ratios by comorbidity and year.

Of the 66 assessed comorbidities, 35 remained associated with HIV– across all model years, 19 remained associated with HIV+ across all model years. Three comorbidities changed association from HIV+ to HIV– and 9 comorbidities changed association from HIV– to HIV+.

The prevalence of comorbidities associated with HIV infection changed over time due to clinical, social, and epidemiological reasons. Comorbidity surveillance can provide important insights into the understanding and management of HIV infection and its consequences.
Ranolazine in the prevention and treatment of atrial fibrillation
Authors: Yuan Chengdai , Luo Wei , Ren Xiaocao , Ya Maxiao , Yan Wenlong , Hui Quanbin
Published: April 2021

Background:

Atrial fibrillation (AF) is the most common clinical arrhythmia and a major cause of morbidity and mortality in clinical practice. This study aims to determine the ranolazine for prevention and treatment of atrial fibrillation.

Method:

This study adheres to the Preferred Reporting Items for Systematic Reviews and Meta-analysis for Protocols. Chinese electronic Database (CBM, Wanfang, and CNKI) and international electronic databases (PubMed, Embase, Cochrane Library, and Web of Science) will be searched for all relevant published articles. We will apply no language or the year of publication restrictions. Study selection, data collection, and assessment of study bias will be conducted independently by a pair of independent reviewers. The Cochrane risk of bias (ROB) tool will be used for the risk of bias assessment. The quality of evidence will be evaluated by Grading of Recommendations Assessment Development and Evaluation (GRADE) system. The statistical analysis of this meta-analysis will be calculated by Review manager version 5.3.

Results:

The results of this study will be published in a peer-reviewed journal.

Conclusion:

This review will evaluate the value of ranolazine interventions for patients with AF, and provide meaningful conclusions or high-level evidence for clinical practice and further research.

Trial registration:

This study protocol was registered in open Science framework (OSF), (Registration DOI: 10.17605/OSF.IO/T6W9Q).
Glycogen storage disease type VI with a novel PYGL mutation
Authors: Zhan Qian , Lv Zili , Tang Qing , Huang Li , Chen Xiuqi , Yang Meixiong , Lan Liancheng , Shan Qingwen
Published: April 2021

Rationale:

Glycogen storage disease (GSD) type VI is a rare disease caused by the inherited deficiency of liver phosphorylase.

Patient concerns:

The proband, a 61-month-old Chinese boy, manifested intermittent hematochezia, growth retardation, hepatomegaly, damage of liver function, mild hypoglycemia, and hyperlactatemia. The other patient was a 107-month-old Chinese girl with growth retardation, hepatomegaly, mild hypoglycemia, and hyperlactatemia. In order to further confirm the diagnosis, we conducted a liver biopsy and detected blood samples for their gene using IDT exon chip capture and high-throughput sequencing.

Diagnoses:

According to the clinical symptoms, physical examination, laboratory examinations, liver biopsy, and the genetic test finding, the 2 patients were diagnosed GSD VI.

Interventions:

They were treated mainly with uncooked cornstarch.

Outcomes:

There were 2 mutations of PYGL gene in this pedigree. c.2467C>T (p. Q823X) and c.2178-2A>C occurred both in the proband and his second sister.

Lessons:

As a novel mutation, c.2178-2A>C enriches the mutation spectrum of PYGL gene. The different degrees of elevated lactate is an unusual phenotype in GSD VI patients. It is not clear if this is caused by the new mutation of c. 2178-2A > C. Long-term complications remains to be observed.
Effectiveness and safety of Liuhe Pill for treating gout
Authors: Yang Chunsheng , Aletengbieke Zulifeiya , Liu Li , Bakeer Banu
Published: April 2021

Background:

Liuhe Pill as a famous traditional Chinese medicine formula is usually used to treat gout, acute pancreatitis, and cellulitis in China. But at present, there is no systematic evaluation report on its therapeutic effectiveness and safety of Liuhe Pill for treating gout. This protocol aims to assess the efficacy and safety of Liuhe Pill for treating gout.

Methods:

We will search the Web of Knowledge, EMBASEWANFANG DATA, China National Knowledge Infrastructure (CNKI), PubMed, ClinicalTrials.gov and Cochrane Library from inception to October 31, 2021 to retrieve relevant studies. We will also search citations of relevant primary and review. Authors of abstract in the meeting will be further searched in PubMed for potential full articles. To minimize the risk of publication bias, we will conduct a comprehensive search that included strategies to find published and unpublished studies. Two authors independently judged study eligibility and extracted data. Heterogeneity will be examined by computing the Q statistic and I

2
statistic.

Results:

This study assessed the efficiency and safety of Liuhe Pill for treating gout.

Conclusions:

This study will provide reliable evidence-based evidence for the clinical application of Liuhe Pill for treating gout.
The efficacy of a multistrain probiotic on cognitive function and risk of falls in patients with cirrhosis
Authors: Wang Na , Yao Wei , Ma Ruiping , Ren Fangfang
Published: April 2021

Objective:

The effect of probiotics on cognitive function and the risk of falling in cirrhosis patients have not been previously evaluated. We perform this protocol for systematic review and meta-analysis to evaluate the effect of a multistrain probiotic on cognitive function and the risk of falls in patients with cirrhosis.

Methods:

An all-round retrieval will be performed in 5 electronic journal databases from their inception to March 2021, which comprise Medline, Pubmed, Embase, ScienceDirect, and the Cochrane Library by 2 independent reviewers. Data extraction was performed independently, and any conflict was resolved before final analysis. Only randomized clinical trials were included in this study. The main endpoints were cognitive function and risk of falls, and the secondary endpoints were fall incidence, health-related quality of life (HRQOL), systemic inflammatory response, gut barrier, bacterial translocation, and fecal microbiota. The risk of bias assessment of the included studies was performed by 2 authors independently using the tool recommended in the Cochrane Handbook for Systematic Reviews of Interventions.

Results:

We hypothesized that the multistrain probiotic improved cognitive function, risk of falls, and inflammatory response in patients with cirrhosis and cognitive dysfunction.

Conclusion:

This study expects to provide credible and scientific clinical evidence for the efficacy and safety of a multistrain probiotic on cognitive function and the risk of falls in patients with cirrhosis.

OSF registration number:

10.17605/OSF.IO/JKMTP.
The effect of comprehensive oral care program on oral health and quality of life in patients undergoing radiotherapy for head and neck cancer
Authors: Lee Hye-Ju , Han Dong-Hun , Kim Jin-Ho , Wu Hong-Gyun
Published: April 2021

Objectives:

The purpose of this study is to investigate the effect of the comprehensive oral care program on oral health status and symptoms in head and neck cancer (HNC) patients undergoing radiotherapy.

Methods:

This was a quasi-experimental study using a non-equivalent control group in non-synchronized design. All participants including control and experimental group were asked for the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire H&N35 (EORTC QLQ-H&N35) and given an oral health education 4 times at baseline, immediate postradiotherapy, 3 months after radiotherapy, and 6 months after radiotherapy. In each visit except for final, the experimental group was given fluoride varnish application and fluoride mouth rinsing solution for daily use. Oral health examination for dental caries, plaque score (PS), bleeding on probing (BOP), and salivary flow rate was performed in baseline and 6 months after radiotherapy. Statistical analyses were done by paired t-tests and mixed ANCOVA repeated-measures analysis.

Results:

From November 1, 2013 to October 31, 2015, a total 61 patients undergoing radiotherapy for HNC cancer were enrolled (30 in control and 31 in experimental groups). Decrease in salivary flow rate was comparable between 2 groups. Dental caries increased in control group (P = .006); PS and BOP were decreased in experimental group (P < .001 and .004, respectively). Experimental group showed lower swallowing, speech problems, and less sexuality scores in EORTC QLQ-H&N35 than control group.

Conclusion:

We found improvement in oral health and the quality of life in HNC patients with comprehensive oral care intervention by dental professionals. Communicating and cooperating between the healthcare and dental professionals is needed to raise the quality of health care services for HNC patients receiving radiotherapy.
Establishment of a clinical diagnostic model for gouty arthritis based on the serum biochemical profile
Authors: Lyu Shang , Ding Ruowen , Yang Shilin , Chen Wanyuan , Rao Yi , OuYang Hui , Liu Peng , Feng Yulin
Published: April 2021

The disease progression of gouty arthritis (GA) is relatively clear, with the 4 stages of hyperuricemia (HUA), acute gouty arthritis (AGA), gouty arthritis during the intermittent period (GIP), and chronic gouty arthritis (CGA). This paper attempts to construct a clinical diagnostic model based on blood routine test data, in order to avoid the need for bursa fluid examination and other tedious steps, and at the same time to predict the development direction of GA.

Serum samples from 579 subjects were collected within 3 years in this study and were divided into a training set (n = 379) and validation set (n = 200). After a series of multivariate statistical analyses, the serum biochemical profile was obtained, which could effectively distinguish different stages of GA. A clinical diagnosis model based on the biochemical index of the training set was established to maximize the probability of the stage as a diagnosis, and the serum biochemical data from 200 patients were used for validation.

The total area under the curve (AUC) of the clinical diagnostic model was 0.9534, and the AUCs of the 5 models were 0.9814 (Control), 0.9288 (HUA), 0.9752 (AGA), 0.9056 (GIP), and 0.9759 (CGA). The kappa coefficient of the clinical diagnostic model was 0.80.

This clinical diagnostic model could be applied clinically and in research to improve the accuracy of the identification of the different stages of GA. Meanwhile, the serum biochemical profile revealed by this study could be used to assist the clinical diagnosis and prediction of GA.
Osteomuscular symptoms on motorcycles in the city of Rio Branco, Acre, Brazil, West Amazon
Authors: Araújo Narjara Campos de , Souza Orivaldo Florêncio de , Morais Mauro José de Deus , Leitão Francisco Naildo Cardoso , Bezerra Italla Maria Pinheiro , Abreu Luiz Carlos de , Rodrigues Luciano Miller Reis
Published: April 2021

Musculoskeletal disorders gradually affect workers in different parts of the world, compromising their occupational health and quality of life. Professionals exposed to these symptoms include the motorcycle taxi driver, whose pain is due to the overuse of the musculoskeletal system and little time to recover it.

To identify the prevalence of musculoskeletal symptoms in motorcycle taxi drivers in the city of Rio Branco, Acre, Brazil, West Amazon.

Cross-sectional study, involving 296 motorcycle taxi drivers in the city of Rio Branco-Acre, Brazil, male, from December 2016 to February 2017. The Nordic Musculoskeletal Questionnaire was used to collect information related to symptoms (pain, discomfort, or numbness) in the last 7 days of work. For the exclusion criteria were, being female; not reside outside the city of Rio Branco, Acre; having less than 3 months of work activity; not be carrying out their work activities at the time of application of the protocol; be limited by clinical or physical issues at the time of application of the protocol. The data obtained in the questionnaire were entered into the Epidata program (Epidata Association, Odense, Denmark) and then transferred to the STATA 10 statistical program (Stata Corp., College Station), for categorization and statistical analysis.

The study population is over 36 years old; most reported having a partner and a higher education level. The average daily working hours of the participants were 12 hours, with the majority working over 12 hours daily. Most of the epidemiological variables factors were associated with musculoskeletal pain when the prevalence and prevalence ratio analyzes were performed. Higher prevalence of musculoskeletal symptoms in the lumbar region is with 17.9%. In the lower limbs, the most affected joint was the ankle (5.7%), followed by the hip (5.07%) and knee (5.07%), respectively. Insomnia was present in 55.35% and self-reported headache in 49.4% of participants.

The musculoskeletal disorders generated by the daily service of motorcycle taxi drivers are directly affecting the quality of life of these professionals.
The efficacy of high-power short-duration radiofrequency for atrial fibrillation ablation
Authors: Zhang Peng , Ma Ling , Wang Fei , Shi Liang
Published: April 2021

Background:

Studies comparing data between the high-power short-duration radiofrequency (HPSR) and low power longer duration therapy were limited and inconsistent. Therefore, we conduct a high-quality systematic review and meta-analysis to assess the efficacy and safety of HPSR on outcomes for patients with atrial fibrillation (AF).

Methods:

The online literature is searched using the following combination of medical subject heading terms: “high-power” OR “high power” AND “radiofrequency” AND “atrial fibrillation.” MEDLINE (PubMed), EMBASE (OVID), Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science (ISI database) will be searched without any language restrictions. All clinical trials to assess the efficacy and safety of HPSR in the treatment of atrial fibrillation will be considered eligible for analysis. The present study will be performed by Review Manager Software (RevMan Version 5.3, The Cochrane Collaboration, Copenhagen, Denmark). Ethical approval and patient consent are not required because this study is a literature-based study.

Results:

This study expects to provide credible and scientific evidence for the efficacy and safety of HPSR on outcomes for patients with AF.

Registration number:

10.17605/OSF.IO/WAEBN.
A study of the sequential treatment of acute heart failure with sacubitril/valsartan by recombinant human brain natriuretic peptide
Authors: Pang Zhihua , Pan Chang , Yao Zhuhua , Ren Ying , Tian Liuyang , Cui Jian , Liu Ximei , Zhang Lijun , Chen Ying
Published: April 2021

This study aimed to investigate the effects of the basic treatment for heart failure and sequential treatment with rh-brain natriuretic peptide (rhBNP) alone or the combination of rhBNP and sacubitril/valsartan. Cardiac structure, pulmonary artery pressure, inflammation and oxidative stress in patients with acute heart failure were evaluated.

Three hundred patients with acute heart failure were included. According to the random number table method, the patients were divided into 3 groups of 100 patients per group: the standard treatment group (treated with an angiotensin-converting enzyme inhibitor, β receptor blocker, and corticosteroid antagonist), rhBNP group (basic treatment combined with rhBNP) and sequential treatment group (basic treatment for heart failure combined with rhBNP followed by sacubitril/valsartan). The changes in NT-probrain natriuretic peptide (BNP) levels, cardiac troponin T (cTnT) levels, cardiac structure, pulmonary artery pressure, and the levels inflammatory factors and oxidative stress factors were compared among the 3 groups at 1, 4, 12, and 36 weeks after treatment.

The sequential treatment group displayed superior outcomes than the standard treatment group and the rhBNP group in terms of left atrium diameter, left ventricular end diastolic volume, left ventricular ejection fraction, pulmonary artery pressure, NT-proBNP levels, and cTnT levels, which respond to damage to the heart structure and myocardium. This result may be related to the decreased levels of inflammatory factors and the correction of oxidative stress imbalance.

Sacubitril/valsartan significantly reduce the serum levels of inflammatory factors in patients with acute heart failure while decreasing the levels of oxidizing factors and increasing the levels of antioxidant factors. These changes may be one of the explanations for the better cardiac structure and better pulmonary artery pressure observed in the sequential treatment group.
Evaluation of clinical trials for natural products used in diabetes
Authors: Ahmad Rizwan , AlLehaibi Lina Hussain , AlSuwaidan Hind Nasser , Alghiryafi Ali Fuad , Almubarak Lyla Shafiq , AlKhalifah Khawlah Nezar , AlMubarak Hawra Jassim , Alkhathami Majed Ali
Published: April 2021

Background relevance:

A plethora of literature is available regarding the clinical trials for natural products however; no information is available for critical assessments of the quality of these clinical trials.

Aim of study:

This is a first time report to critically evaluate the efficacy, safety and large scale applications of up-to-date clinical trials for diabetes, based on the three scales of Jadad, Delphi, and Cochrane.

Methodology:

An in-depth and extensive literature review was performed using various databases, journals, and books. The keywords searched included, “clinical trials,” “clinical trial in diabetes,” “diabetes,” “natural products in diabetes,” “ethnopharmacological relevance of natural products in diabetes,” etc.

Results:

Based on eligibility criteria, 16 plants with 74 clinical trials were found and evaluated. Major drawbacks observed were; “non-randomization and blindness of the studies,” “non-blindness of patients/healthcare/outcome assessors,” “lack of patient compliance and co-intervention reports,” “missing information regarding drop-out/withdrawal procedures,” and “inappropriate baseline characteristics.” Principal component analysis and Pearson correlation revealed four components with %variability; PC1: 23.12, PC2: 15.83, PC3: 13.11, and PC4: 11.38 (P ≤ .000). According to descriptive statistics, “non-blinding of outcome assessors” was the major drawback (82%) whereas, “not mentioning the timing of outcome assessment” was observed lowest (6.8%). An in-house quality grading (scale 0–24) classified these clinical trials as; poor (67.6%), acceptable (19.9%), and good quality trials (13.5%).

Conclusion:

Proper measures in terms of more strict regulations with pharmacovigilance of plants are utmost needed in order to achieve quality compliance of clinical trials.
Conducting a Virtual Research Symposium
Authors: Merritt Sharon , Kramer Margaret , Monroe Martha , Davies Claire C.
Published: April 2021

Strategies used to change an annual statewide research symposium from a face-to-face experience to a virtual event at a 434-bed Magnet® redesignated community hospital are described. The program met with success and increased access for attendees. For the 1st time, credited to the virtual format, representatives from all 9 hospitals in the system were able to attend. Feedback following the symposium suggested that participants who live at a distance from the hospital appreciated being able to attend the meeting without traveling, technical issues were promptly resolved, and presenters received positive evaluations.
Clinical Neurophysiology Fellowship Program Directors Survey on a Standardized Fellowship Match Process: A Call for Action
Authors: Karakis Ioannis , Liu Lynn , Bensalem-Owen Meriem , LaRoche Suzette M. , Lopez Jaime R. , Schmitt Sarah E. , Britton Jeffrey W. , Nuwer Marc R. , Lee Leslie H. , Rubin Devon I. , Laughlin Ruple S. , Sinha Saurabh R.
Published: April 2021

Purpose:

To survey US Clinical Neurophysiology (CNP) fellowship program directors on the nature of CNP and related training programs, current recruitment cycle, and views for a standardized process.

Methods:

A 23-question electronic survey was sent to all 93 US Accreditation Council for Graduate Medical Education-accredited CNP fellowship program directors from December 2020 to January 2021.

Results:

The response rate was 60%. There was great variability in the number of CNP positions and CNP tracks offered. The following tracks were identified: 48% EEG dominant, 26% EMG dominant, 22% split equally between EEG and EMG, and 2% and 1% were neurophysiologic intraoperative monitoring and autonomic dominant, respectively. Of the responding institutions, 43% offered a second year of training options to CNP fellows, mainly in conjunction with Epilepsy fellowship, which was pursued by 25% of CNP fellows. Many programs indicated flexibility in their design between different CNP tracks or between CNP and other related training programs based on the available candidates. The median percentage of CNP fellowship positions filled over the last 5 years was 80%, and there was great variation in the recruitment timeline across institutions. Overall, 86% of program directors favored a universal timeline and 71% favored a formal match for CNP. The respondents were split between an independent CNP match (39%) and joining the initiatives of affiliate societies on a standardized process (61%).

Conclusions:

There is significant heterogeneity in the makeup of the CNP fellowship programs and the recruitment process. The majority of CNP program directors are in favor of standardization of the recruitment process.
Ferroptosis in myocardial infarction: not a marker but a maker
Authors: Wang Xiao-dong , Kang Sheng
Published: April 2021

Identification of effective cardiac biomarkers and therapeutic targets for myocardial infarction (MI) will play an important role in early diagnosis and improving prognosis. Ferroptosis, a cell death process driven by cellular metabolism and iron-dependent lipid peroxidation, has been implicated in diseases such as ischaemic organ damage, cancer and neurological diseases. Its modulators were involved in transferrin receptor, iron chelator, clock protein ARNTL, etc. Its mechanisms included the inhibition of system X
C
−
, diminished GPX4 activity, change of mitochondrial voltage-dependent anion channels and rising intracellular reactive oxygen species level. Further, the inhibitors of apoptosis, pyroptosis and autophagy did not prevent the occurrence of ferroptosis, but iron chelating agents and antioxidants could inhibit it. Noticeably, ferroptosis is an important pattern of cardiomyocyte death in the infarcted area, which may play a vital role in support of the myocardial pathological process of heart disease. However, the molecular mechanism of ferroptosis in the pathogenesis and the development of MI is not clear. Therefore, a greater depth of exploration of the mechanism of ferroptosis and its inhibitors will undoubtedly improve the pathological process of MI, which may be expected to identify ferroptosis as novel diagnostic and therapeutic targets of MI.
Communicating personalized risks from COVID-19: guidelines from an empirical study
Authors: Freeman Alexandra L. J. , Kerr John , Recchia Gabriel , Schneider Claudia R. , Lawrence Alice C. E. , Finikarides Leila , Luoni Giulia , Dryhurst Sarah , Spiegelhalter David
Published: April 2021

As increasing amounts of data accumulate on the effects of the novel coronavirus SARS-CoV-2 and the risk factors that lead to poor outcomes, it is possible to produce personalized estimates of the risks faced by groups of people with different characteristics. The challenge of how to communicate these then becomes apparent. Based on empirical work (totaln= 5520, UK) supported by in-person interviews with the public and physicians, we make recommendations on the presentation of such information. These include: using predominantly percentages when communicating the absolute risk, but also providing, for balance, a format which conveys a contrasting (higher) perception of risk (expected frequency out of 10 000); using a visual linear scale cut at an appropriate point to illustrate the maximum risk, explained through an illustrative ‘persona’ who might face that highest level of risk; and providing context to the absolute risk through presenting a range of other ‘personas’ illustrating people who would face risks of a wide range of different levels. These ‘personas’ should have their major risk factors (age, existing health conditions) described. By contrast, giving people absolute likelihoods of other risks they face in an attempt to add context was considered less helpful. We note that observed effect sizes generally were small. However, even small effects are meaningful and relevant when scaled up to population levels.
Variational principles of liquid–porous material interactions with applications to approximate solutions and finite-element modelling
Authors: Xing Jing Tang , Qin Hongling
Published: April 2021

For liquid–porous material interactions (LPMI), three variational principles are developed in Biot's theory of porous materials in association with Darcy's Law. First one takes solid acceleration, and fluid velocity, acceleration, pressure with time derivative as five variables, while second and third, respectively, have three and two variables when Darcy's Law used as variational constraint reducing variables. These principles provide a means to derive approximate solutions and finite-element (FE) models for LPMI. Each LPMI element includes fluid and solid together with it being no longer necessary to distinguish fluid domain from solid. Examples illustrate applications to establish FE model for numerical solutions of LPMI. Solution of a one-dimensional problem reveals that LPMI behaves a coupled-frequency separation measured by a defined-coupling factor. Dynamic response explores coupled-dynamic absorber mechanism in LPMI system, from which it is found that the external force at fluid does not contribute to fluid response but fully absorbed by solid local resonance if the force frequency equals the solid natural frequency; while in the reverse case when the force frequency equals the fluid one, the force at solid does not produce the solid response but fully absorbed by fluid local resonance. New findings with defined LPMI coupling factor provide guidelines for designing LPMI system with expected dynamic behaviour meeting engineering requirements.
Manifestation of the Berry curvature in geophysical ray tracing
Authors: Perez N. , Delplace P. , Venaille A.
Published: April 2021

Geometrical phases, such as the Berry phase, have proven to be powerful concepts to understand numerous physical phenomena, from the precession of the Foucault pendulum to the quantum Hall effect and the existence of topological insulators. The Berry phase is generated by a quantity named the Berry curvature, which describes the local geometry of wave polarization relations and is known to appear in the equations of motion of multi-component wave packets. Such a geometrical contribution in ray propagation of vectorial fields has been observed in condensed matter, optics and cold atom physics. Here, we use a variational method with a vectorial Wentzel–Kramers–Brillouin ansatz to derive ray- tracing equations for geophysical waves and to reveal the contribution of the Berry curvature. We detail the case of shallow-water wave packets and propose a new interpretation of their oscillating motion around the equator. Our result shows a mismatch with the textbook scalar approach for ray tracing, by predicting a larger eastward velocity for Poincaré wave packets. This work enlightens the role of the geometry of wave polarization in various geophysical and astrophysical fluid waves, beyond the shallow-water model.
An axisymmetric problem for a penny-shaped crack under the influence of the Steigmann–Ogden surface energy
Authors: Zemlyanova Anna Y.
Published: April 2021

A problem for a nanosized penny-shaped fracture in an infinite homogeneous isotropic elastic medium is considered. The fracture is opened by applying an axisymmetric normal traction to its surface. The surface energy in the Steigmann–Ogden form is acting on the boundary of the fracture. The problem is solved by using the Boussinesq potentials represented by the Hankel transforms of certain unknown functions. With the help of these functions, the problem can be reduced to a system of two singular integro-differential equations. The numerical solution to this system can be obtained by expanding the unknown functions into the Fourier–Bessel series. Then the approximations of the unknown functions can be obtained by solving a system of linear algebraic equations. Accuracy of the numerical procedure is studied. Various numerical examples for different values of the surface energy parameters are considered. Parametric studies of the dependence of the solutions on the mechanical and the geometric parameters of the system are undertaken. It is shown that the surface parameters have a significant influence on the behaviour of the material system. In particular, the presence of surface energy leads to the size-dependency of the solutions and smoother behaviour of the solutions near the tip of the crack.
Asymptotic solution to convolution integral equations on large and small intervals
Authors: Ponomarev Dmitry
Published: April 2021

We consider convolution integral equations on a finite interval with a real-valued kernel of even parity, a problem equivalent to finding a Wiener–Hopf factorization of a notoriously difficult class of 2 × 2 matrices. The kernel function is assumed to be sufficiently smooth and decaying for large values of the argument. Without loss of generality, we focus on a homogeneous equation and we propose methods to construct explicit asymptotic solutions when the interval size is large and small. The large interval method is based on a reduction of the original equation to an integro-differential equation on a half-line that can be asymptotically solved in a closed form. This provides an alternative to other asymptotic techniques that rely on fast (typically exponential) decay of the kernel function at infinity, which is not assumed here. We also consider the problem on a small interval and show that finding its asymptotic solution can be reduced to solving an ODE. In particular, approximate solutions could be constructed in terms of readily available special functions (prolate spheroidal harmonics). Numerical illustrations of the obtained results are provided and further extensions of both methods are discussed.
Town population size and structuring into villages and households drive infectious disease risks in pre-healthcare Finland
Authors: Ketola Tarmo , Briga Michael , Honkola Terhi , Lummaa Virpi
Published: April 2021

Social life is often considered to cost in terms of increased parasite or pathogen risk. However, evidence for this in the wild remains equivocal, possibly because populations and social groups are often structured, which affects the local transmission and extinction of diseases. We test how the structuring of towns into villages and households influenced the risk of dying from three easily diagnosable infectious diseases—smallpox, pertussis and measles—using a novel dataset covering almost all of Finland in the pre-healthcare era (1800–1850). Consistent with previous results, the risk of dying from all three diseases increased with the local population size. However, the division of towns into a larger number of villages decreased the risk of dying from smallpox and to some extent of pertussis but it slightly increased the risk for measles. Dividing towns into a larger number of households increased the length of the epidemic for all three diseases and led to the expected slower spread of the infection. However, this could be seen only when local population sizes were small. Our results indicate that the effect of population structure on epidemics, disease or parasite risk varies between pathogens and population sizes, hence lowering the ability to generalize the consequences of epidemics in spatially structured populations, and mapping the costs of social life, via parasites and diseases.
Species-specific but not phylosymbiotic gut microbiomes of New Guinean passerine birds are shaped by diet and flight-associated gut modifications
Authors: Bodawatta Kasun H. , Koane Bonny , Maiah Gibson , Sam Katerina , Poulsen Michael , Jønsson Knud A.
Published: April 2021

Animal hosts have evolved intricate associations with microbial symbionts, where both depend on each other for particular functions. In many cases, these associations lead to phylosymbiosis, where phylogenetically related species harbour compositionally more similar microbiomes than distantly related species. However, evidence for phylosymbiosis is either weak or lacking in gut microbiomes of flying vertebrates, particularly in birds. To shed more light on this phenomenon, we compared cloacal microbiomes of 37 tropical passerine bird species from New Guinea using 16S rRNA bacterial gene sequencing. We show a lack of phylosymbiosis and document highly variable microbiomes. Furthermore, we find that gut bacterial community compositions are species-specific and tend to be shaped by host diet but not sampling locality, potentially driven by the similarities in habitats used by individual species. We further show that flight-associated gut modifications, coupled with individual dietary differences, shape gut microbiome structure and variation, contributing to the lack of phylosymbiosis. These patterns indicate that the stability of symbiosis may depend on microbial functional diversity rather than taxonomic composition. Furthermore, the more variable and fluid host–microbe associations suggest probable disparities in the potential for coevolution between bird host species and microbial symbionts.
Phylogeny, function and ecology in the deep evolutionary history of the mammalian forelimb
Authors: Lungmus Jacqueline K. , Angielczyk Kenneth D.
Published: April 2021

Mammals are the only living members of the larger clade Synapsida, which has a fossil record spanning 320 Ma. Despite the fact that much of the ecological diversity of mammals has been considered in the light of limb morphology, the ecological comparability of mammals to their fossil forerunners has not been critically assessed. Because of the wide use of limb morphology in testing ecomorphological hypothesis about extinct tetrapods, we sought: (i) to estimate when in synapsid history, modern mammals become analogues for predicting fossil ecologies; (ii) to document examples of ecomorphological convergence; and (iii) to compare the functional solutions of distinct synapsid radiations. We quantitatively compared the forelimb shapes of the multiple fossil synapsid radiations to a broad sample of extant Mammalia representing a variety of divergent locomotor ecologies. Our results indicate that each synapsid radiation explored different areas of morphospace and arrived at functional solutions that reflected their distinctive ancestral morphologies. This work counters the narrative of non-mammalian synapsid forelimb evolution as a linear progression towards more mammalian morphologies. Instead, a disparate array of early-evolving shapes subsequently contracted towards more mammal-like forms.
Machine Learning Prediction of Surgical Intervention for Small Bowel Obstruction
Authors: Turpin Miles , Watson Joshua , Engelhard Matthew , Henao Ricardo , Thompson David , Carin Lawrence , Kirk Allan
Published: April 2021

Small bowel obstruction (SBO) results in >350,000 operations and >$2 billion annual health care expenditures in the US. Prompt, effective identification of patients at high/low surgery risk could improve survival, lower complication rates, and shorten hospitalization lengths. SBO surgery prediction models were developed based on SBO-related encounters in the Duke University Health System between 2013 and 2017. A total of 3,910 encounters among 3,374 unique patients were identified. Performance was assessed in each hour after admission when predicting whether patients will (a) receive surgery within 24 hours, and (b) receive surgery during the current encounter. Potential benefits of model-based discharge were assessed using the incorrect discharge rate and average reduction in hospital stay. Model-based discharge of low-risk patients was projected to reduce the average length of stay among patients not receiving surgery by >60 hours while maintaining an incorrect discharge rate lower than the observed readmission rate (9.3%). AUROC for the 24-hour prediction task increased from 0.644 to 0.779 at 12 and 72 hours post-admission, respectively. Future work will prospectively explore the benefits of model deployment in an inpatient setting.