bluuebunny/crossref_metadata_2025 huggingface dataset:
The Relationship Between Habitual Physical Activity, Sitting Time, and Cognitive Function in Young Adult Women
Authors: Peng Cox Eka , Cook Rebecca , O’Dwyer Nicholas , Donges Cheyne , Parker Helen , Lun Cheng Hoi , Steinbeck Katharine , Franklin Janet , O’Connor Helen
Published: June 2021

Background: There is evidence that physical activity (PA), sitting time, and obesity may impact cognition, but few studies have examined this in young women. Methods: Healthy women (18–35 y), without conditions that impair cognition, were recruited for this cross-sectional study. Participants completed anthropometric and validated computerized cognitive assessments (IntegNeuro™). Performance on 5 cognitive domains (impulsivity, attention, information processing, memory, and executive function) was reported as z scores. Sitting hours and weekly PA calculated from time in low-, moderate-, and high-intensity activity were obtained via the International Physical Activity Questionnaire. Analysis of variance/analysis of covariance, chi-square, and linear regression were used. Results: 299 (25.9 [5.1] y) women (low PA = 19%; moderate PA = 40%; high PA = 41%) participated. High PA women had lower body mass index (high PA = 26.1 [6.5]; moderate PA = 30.0 [8.7]; low PA = 31.0 [11.1] kg/m2; P < .001) and less sitting time (high PA = 6.6 [3.1]; moderate PA = 7.7 [2.8]; low PA = 9.3 [3.6] hr/weekday; P < .0001). Cognitive function was within normal ranges and did not differ between any PA groups (P = .42). Adjusting for body mass index, C-reactive protein, or sitting hours did not alter results. Weak correlations were found between time in high-intensity activity and impulsivity (b = 0.12, r2 = .015; P = .04), and between sitting hours and information processing efficiency (b = −0.18, r2 = .03; P = .002). Valuesare presented as mean (SD). Conclusions: Cognitive function was within the normal range, regardless of PA or sitting time.
Effects of Long-Duration Home Isolation Linked to the COVID-19 Pandemic on Mental Health of Adolescent Athletes
Authors: Denerel Nevzad , Şenışık Seçkin , Köyağasıoğlu Ogün , Çiğdem Sema , Tunç Serhat
Published: June 2021

Purpose: To assess whether adolescent athletes were affected or not in terms of mental health by the long duration at home linked to isolation enforced during the COVID-19 pandemic. Method: The study included 940 team athletes, 274 individual athletes, and 131 nonathlete controls aged 12–17 years. Demographic data were obtained with a form including questions about age, sex, sports type, and physical activity status (type, duration, and frequency) during the isolation period. Participants completed the Children’s Revised Impact of Event Scale-13, Center for Epidemiological Studies Depression Scale for Children, and State-Trait Anxiety Inventory for Children. Results: Among participants, 88% did not meet the physical activity recommendations for children and adolescents, while 42.8% felt depressed. Depressive symptoms were present in 38.1% of boys and 59.7% of girls, with girls (6.4%) having higher posttraumatic stress symptoms than boys (3.5%). Among athletes, depressive and anxiety symptoms were lower compared with nonathlete controls (P < .01). Posttraumatic stress symptoms were lower among athletes than nonathlete controls for girls (team vs control, P = .006; individual vs control, P = .002) but similar for boys (P > .05). The depression (P = .518), state (P = .866), and trait anxiety (P = .507) symptoms were similar between team athletes and individual athletes. Conclusion: Though adolescent athletes’ depression, anxiety, and posttraumatic stress symptoms were significantly lower than nonathlete controls, athletes also had high depression levels. These findings show the need to take precautions to protect the psychological health of not only nonathletes, but also athletes in the pandemic period.
Identification of a High-Frequency Intrahost SARS-CoV-2 Spike Variant with Enhanced Cytopathic and Fusogenic Effects
Authors: Rocheleau Lynda , Laroche Geneviève , Fu Kathy , Stewart Corina M. , Mohamud Abdulhamid O. , Côté Marceline , Giguère Patrick M. , Langlois Marc-André , Pelchat Martin
Published: June 2021

The mutation rate and evolution of RNA viruses correlate with viral adaptation. While most mutations do not make significant contributions to viral molecular evolution, some are naturally selected and produce variants through positive selection.
FRQ-CK1 Interaction Underlies Temperature Compensation of the
Neurospora
Circadian Clock
Authors: Hu Yue , Liu Xiaolan , Lu Qiaojia , Yang Yulin , He Qun , Liu Yi , Liu Xiao
Published: June 2021

Temperature compensation allows clocks to adapt to all seasons by having a relatively constant period length at different physiological temperatures, but the mechanism of temperature compensation is unclear. Stability of clock proteins was previously proposed to be a major factor that regulated temperature compensation.
Cellular Calcium Levels Influenced by NCA-2 Impact Circadian Period Determination in
Neurospora
Authors: Wang Bin , Zhou Xiaoying , Gerber Scott A. , Loros Jennifer J. , Dunlap Jay C.
Published: June 2021

Circadian rhythms are based on cell-autonomous, auto-regulatory feedback loops formed by interlocked positive and negative arms, and they regulate myriad molecular and cellular processes in most eukaryotes, including fungi. Intracellular calcium signaling is also a process that impacts a broad range of biological events in most eukaryotes.
Effectors of the Stenotrophomonas maltophilia Type IV Secretion System Mediate Killing of Clinical Isolates of Pseudomonas aeruginosa
Authors: Nas Megan Y. , Gabell Jeffrey , Cianciotto Nicholas P.
Published: June 2021

S. maltophilia
is an increasingly important opportunistic pathogen. Inherently resistant to many antibiotics,
S. maltophilia
is often associated with lung infection, being, among other things, a complicating factor in cystic fibrosis patients.
Ecophysiology of the Cosmopolitan OM252 Bacterioplankton (
Gammaproteobacteria
)
Authors: Savoie Emily R. , Lanclos V. Celeste , Henson Michael W. , Cheng Chuankai , Getz Eric W. , Barnes Shelby J. , LaRowe Douglas E. , Rappé Michael S. , Thrash J. Cameron
Published: June 2021

Marine microbial communities are teeming with understudied taxa due to the sheer numbers of species in any given sample of seawater. One group, the OM252 clade of
Gammaproteobacteria
, has been identified in gene surveys from myriad locations, and one isolated organism has even been genome sequenced (HIMB30).
VZV myelitis with secondary HIV CSF escape
Authors: Weiss Julian J , Spudich Serena , Barakat Lydia
Published: June 2021

A 52-year-old woman with HIV and recent antiretroviral therapy non-adherence presented with a 5-day history of widespread painful vesicular skin lesions. Direct fluorescent antibody testing of the skin lesions was positive for varicella zoster virus (VZV). On day 3, she developed profound right upper extremity weakness. MRI of the brain and cervical spine was suggestive of VZV myelitis. Lumbar puncture was positive for VZV PCR in the cerebrospinal fluid (CSF) and CSF HIV viral load was detected at 1030 copies/mL, indicating ‘secondary’ HIV CSF escape. She was treated with intravenous acyclovir for 4 weeks and subsequent oral therapy with famciclovir then valacyclovir for 6 weeks. She also received dexamethasone. The patient had an almost full recovery at 6 months. Myelitis is a rare complication of reactivated VZV infection that can have atypical presentation in immunocompromised patients. Such ‘secondary’ HIV CSF escape should be considered in immunosuppressed patients with concomitant central nervous system infection.
Normal inflammatory markers in giant cell arteritis with long-standing cranial and symptomatic large-vessel involvement
Authors: Rodriguez-Pla Alicia , Naidu Sailendra G , Butt Yasmeen M , Davila Victor J
Published: June 2021

We report the case of a 78-year-old woman who presented with cardiovascular risk factors and a history of an atypical transient ischaemic attack. She was referred by her primary care physician to the vascular surgery department at our institution for evaluation of progressive weakness, fatigue, arm claudication and difficulty assessing the blood pressure in her right arm. She was being considered for surgical revascularisation, but a careful history and review of her imaging studies raised suspicion for vasculitis, despite her normal inflammatory markers. She was eventually diagnosed with biopsy-proven giant cell arteritis with diffuse large-vessel involvement. Her symptoms improved with high-dose glucocorticoids.
Comparative analysis of reported physical activity from leisure centres’ members versus the general population in Spain
Authors: López Fernández Jorge , López-Valenciano Alejandro , Mayo Xián , Horton Elizabeth , Clavel Ivan , Liguori Gary , Jiménez Alfonso
Published: June 2021

Objectives

(1) To describe the physical activity (PA) levels of the members of a Spanish leisure centre operator according to age and gender; (2) to describe the differences in the three PA levels between the members of a Spanish leisure centre operator and the general Spanish population considering the PA Eurobarometer data according to their gender and age and (3) to explore the intensity origin of the PA either in Spanish members of leisure centres or the Spanish population considering their gender.

Design

Descriptive epidemiology study.

Participants

Data from 16 Spanish leisure centres (n=3627) and from the 2017 Eurobarometer 472 for Spain (n=1002) were used for this research.

Primary and secondary outcomes measures

The PA levels were analysed with the International Physical Activity Questionnaire short version, and respondents were grouped into physical inactivity (PIA), moderate-PA and high-PA. Moreover, gender (men or women) and age (18–29 years; 30–44 years; 45–59 years; 60–69 years; ≥70 years) were considered. Total metabolic equivalent (MET)-min/week, as well as total MET-min/week for walking intensity, moderate intensity and vigorous intensity were recorded.

Results

Leisure centres showed a lower prevalence of PIA and a higher prevalence of high-PA than the general population (p<0.05). Women displayed a higher prevalence of PIA and lower prevalence of high-PA than men (p<0.05). The prevalence of PIA increases with age while the prevalence of high-PA decreases.

Conclusion

Leisure centres engage most of their members in regular PA, including women and older adults, and these members also perform a higher number of MET in vigorous PA, than the general population.
Baseline risk factor prevalence among adolescents aged 15–17 years old: findings from National Non-communicable Disease Monitoring Survey (NNMS) of India
Authors: Mathur Prashant , Kulothungan Vaitheeswaran , Leburu Sravya , Krishnan Anand , Chaturvedi Himanshu Kumar , Salve Harshal Ramesh , Amarchand Ritvik , Nongkynrih Baridalyne , Ganeshkumar Parasuraman , Urs K S Vinay , Laxmaiah A , Boruah Manjit , Kumar Sanjeev , Patro Binod Kumar , Raghav Pankaja Ravi , Rajkumar Prabu , Sarma P Sankara , Sharma Rinku , Tambe Muralidhar , Arlappa N , Mahanta Tulika Goswami , Bhuyan Pranab Jyoti , Joshi Rajnish P , Pakhare Abhijit , Galhotra Abhiruchi , Kumar Dewesh , Behera Binod Kumar , Topno Roshan K , Gupta Manoj Kumar , Rustagi Neeti , Trivedi Atulkumar V , Thankappan K R , Gupta Sonia , Garg Suneela , Shelke Sangita Chandrakant
Published: June 2021

Objective

To generate national estimates of key non-communicable disease (NCD) risk factors for adolescents (15–17 years) identified in the National NCD Monitoring Framework and, study the knowledge, attitudes and practices towards NCD risk behaviours among school-going adolescents.

Design and setting

A community-based, national, cross-sectional survey conducted during 2017–2018. The survey was coordinated by the Indian Council of Medical Research—National Centre for Disease Informatics and Research with 10 reputed implementing research institutes/organisations across India in urban and rural areas.

Participants

A multistage sampling design was adopted covering ages between 15 and 69 years—adolescents (15–17 years) and adults (18–69 years). The sample included 12 000 households drawn from 600 primary sampling units. All available adolescents (15–17 years) from the selected households were included in the survey.

Main outcome measures

Key NCD risk factors for adolescents (15–17 years)—current tobacco and alcohol use, dietary behaviours, insufficient physical activity, overweight and obesity.

Results

Overall, 1402 households and 1531 adolescents completed the survey. Prevalence of current daily use of tobacco was 3.1% (95% CI: 2.0% to 4.7%), 25.2% (95% CI: 22.2% to 28.5%) adolescents showed insufficient levels of physical activity, 6.2% (95% CI: 4.9% to 7.9%) were overweight and 1.8% (95% CI: 1.0% to 2.9%) were obese. Two-thirds reported being imparted health education on NCD risk factors in their schools/colleges.

Conclusion

The survey provides baseline data on NCD-related key risk factors among 15–17 years in India. These national-level data fill information gaps for this age group and help assess India’s progress towards NCD targets set for 2025 comprehensively. Though the prevalence of select risk factors is much lower than in many developed countries, this study offers national evidence for revisiting and framing appropriate policies, strategies for prevention and control of NCDs in younger age groups.
Liver fat content is independently associated with microalbuminuria in a normotensive, euglycaemic Chinese population: a community-based, cross-sectional study
Authors: Li Xiaoming , Xia Mingfeng , Ma Hui , Hu Yu , Yan Hongmei , He Wanyuan , Lin Huandong , Zhao Nai Qing , Gao Jian , Gao Xin
Published: June 2021

Objective

Non-alcoholic fatty liver disease (NAFLD) is associated with microalbuminuria (MA) in patients with diabetes/pre-diabetes. Whether this association is mediated by blood glucose and blood pressure (BP) remains unclear. This study investigated whether liver fat content (LFC) was associated with MA in a normotensive and non-diabetic population.

Design

A cross-sectional substudy.

Settings

LFC was determined from the hepatic/renal echogenicity ratio at ultrasound. MA was defined as an albumin-to-creatinine ratio (ACR) of 30–300 µg/mg (early- morning urine sample). Multivariable logistic regression and receiver operating characteristic (ROC) curve analyses were used to evaluate LFC as a predictor of MA.

Participants

Between May 2010 and June 2011, this cross-sectional, community-based study enrolled residents from Shanghai (China), aged ≥40 years and with normal glucose tolerance and BP.

Results

A total of 550 residents (median age, 57 years; 174 men) were enrolled and stratified according to LFC quartiles. ACR (p<0.001) and MA prevalence (p=0.012) increased across the LFC quartiles. Multivariable logistic regression showed that the OR for MA (per SD increase in LFC) was 1.840 (95% CI 1.173 to 2.887, p=0.008) after adjustment for potential confounders including age, gender, waist-hip ratio, blood urea nitrogen, systolic and diastolic BP, fasting blood glucose, postprandial glucose, low-density lipoprotein-cholesterol, triglycerides, high-density lipoprotein-cholesterol, total cholesterol, estimated glomerular filtration rate and lipid-lowering drugs. The ROC analysis revealed that the optimal LFC cut-off value for predicting MA was 6.82%.

Conclusion

LFC is independently associated with MA in normotensive, euglycaemic middle-aged and elderly Chinese individuals. Screening for MA in people with NAFLD might facilitate early intervention to minimise kidney disease risk.
Knowledge and perceptions of COVID-19, prevalence of pre-existing conditions and access to essential resources in Somali IDP camps: a cross-sectional study
Authors: Alawa Jude , Al-Ali Samir , Walz Lucas , Wiles Eleanor , Harle Nikhil , Awale Mohamed Abdullahi , Mohamed Deqo , Khoshnood Kaveh
Published: June 2021

Objectives

This study examined knowledge and perceptions of COVID-19, prevalence of pre-existing conditions and access to essential resources among residents of internally displaced person (IDP) camps in Somalia, where overcrowded settlements with weakened infrastructure, inadequate water, sanitation, and hygiene facilities, and limited access to health services make this vulnerable population particularly susceptible to a COVID-19 outbreak.

Design

A descriptive, cross-sectional survey.

Setting

Twelve IDP camps across six areas of the Lower Shabelle region in Somalia.

Participants

401 adult Somali IDP camp residents.

Results

The majority of participants were female (86%) and had received no formal education (89%). While 58% reported being in ‘good’ health, half of the participants reported having one or more pre-existing conditions. Though 77% of respondents reported taking at least one COVID-19 preventative public health measure, respondents reported a lack of access to adequate sanitation, an inability to practice social distancing and nearly universal inability to receive a COVID-19 screening exam. Questions assessing knowledge surrounding COVID-19 prevention and treatment yielded answers of ‘I don’t know’ for roughly 50% of responses. The majority of participants were not familiar with basic information about the virus or confident that they could receive medical services if infected. 185 (47%) respondents indicated that camp living conditions needed to change to prevent the spread of COVID-19.

Conclusion

This study highlights low levels of COVID-19 knowledge and limited access to essential prevention and treatment resources among individuals living in Somali IDP camps. A massive influx of additional resources is required to adequately address COVID-19 in Somalia, starting with codesigning interventions to educate those individuals most vulnerable to infection.
Decreasing ICU-associatedClostridioides difficileinfection through fluoroquinolone restriction, the FIRST trial: a study protocol
Authors: Safdar Nasia , Parmasad Vishala , Brown Roger , Carayon Pascale , Lepak Alexander , O"Horo John C , Schulz Lucas
Published: June 2021

Introduction

Clostridioides difficileinfection (CDI) is one of the most common healthcare-associated infections in the USA, having high incidence in intensive care units (ICU). Antibiotic use increases risk of CDI, with fluoroquinolones (FQs) particularly implicated. In healthcare settings, antibiotic stewardship (AS) and infection control interventions are effective in CDI control, but there is little evidence regarding the most effective AS interventions. Preprescription authorisation (PPA) restricting FQs is a potentially promising AS intervention to reduce CDI. The FQ Restriction for the Prevention of CDI (FIRST) trial will evaluate the effectiveness of an FQ PPA intervention in reducing CDI rates in adult ICUs compared with preintervention care, and evaluate implementation effectiveness using a human-factors and systems engineering model.

Methods and analysis

This is a multisite, stepped-wedge, cluster, effectiveness-implementation clinical trial. The trial will take place in 12 adult medical-surgical ICUs with ≥10 beds, using Epic as electronic health record (EHR) and pre-existing AS programmes. Sites will receive facilitated implementation support over the 15-month trial period, succeeded by 9 months of follow-up. The intervention comprises a clinical decision support system for FQ PPA, integrated into the site EHRs. Each ICU will be considered a single site and all ICU admissions included in the analysis. Clinical data will be extracted from EHRs throughout the trial and compared with the corresponding pretrial period, which will constitute the baseline for statistical analysis. Outcomes will include ICU-onset CDI rates, FQ days of therapy (DOT), alternative antibiotic DOT, average length of stay and hospital mortality. The study team will also collect implementation data to assess implementation effectiveness using the Systems Engineering Initiative for Patient Safety model.

Ethics and dissemination

The trial was approved by the Institutional Review Board at the University of Wisconsin-Madison (2018-0852-CP015). Results will be made available to participating sites, funders, infectious disease societies, critical care societies and other researchers.

Trial registration number

NCT03848689.
Protocol for surgical and non-surgical treatment for metacarpal shaft fractures in adults: an observational feasibility study
Authors: Taha Rowa , Leighton Paul , Bainbridge Chris , Montgomery Alan , Davis Tim , Karantana Alexia
Published: June 2021

Introduction

Metacarpal shaft fractures (MSF) are common traumatic hand injuries that usually affect young people of working age. They place a significant burden on healthcare resources and society; however, there is a lack of evidence to guide their treatment. Identifying the most beneficial and cost-efficient treatment will ensure optimisation of care and provide economic value for the National Health Service. The aim of this study is to assess the feasibility of a randomised controlled trial comparing surgical and non-surgical treatment for MSF in adults.

Methods and analysis

This is a multicentre prospective cohort study, with a nested qualitative study consisting of patient interviews and focus groups, and an embedded factorial randomised substudy evaluating the use of text messages to maximise data collection and participant retention. The outcomes of interest include eligibility, recruitment and retention rates, completion of follow-up, evaluation of primary outcome measures, calculation of the minimal clinically important difference (MCID) for selected outcome measures and establishing the feasibility of data collection methods and appropriate time-points for use in a future trial. Data will be captured using a secure online data management system. Data analyses will be descriptive and a thematic inductive analysis will be used for qualitative data. Minimum clinically important effects for each patient-reported outcome measure will be estimated using anchor-based responsiveness statistics and distribution-based methods.

Ethics and dissemination

This study has received ethical approval from the Research Ethics Committee and the Health Research Authority (REC reference 20/EE/0124). Results will be made available to patients, clinicians, researchers and the funder via peer-reviewed publications and conference presentations. Social media platforms, local media and feedback from the Patient Advisory Group will be used to maximise circulation of findings to patients and the public.

Trial registration number

ISRCTN13922779.
Prevalence and incidence of anti-SARS-CoV-2 antibodies among healthcare workers in Belgian hospitals before vaccination: a prospective cohort study
Authors: Mortgat Laure , Verdonck Kristien , Hutse Veronik , Thomas Isabelle , Barbezange Cyril , Heyndrickx Leo , Fischer Natalie , Vuylsteke Bea , Kabouche Ines , Ariën Kevin K , Desombere Isabelle , Duysburgh Els
Published: June 2021

Objectives

To describe prevalence and incidence of anti-SARS-CoV-2 antibodies among Belgian hospital healthcare workers (HCW) in April–December 2020.

Design

Prospective cohort study. Follow-up was originally planned until September and later extended.

Setting

Multicentre study, 17 hospitals.

Participants

50 HCW were randomly selected per hospital. HCW employed beyond the end of the study and whose profession involved contact with patients were eligible. 850 HCW entered the study in April–May 2020, 673 HCW (79%) attended the September visit and 308 (36%) the December visit.

Outcome measures

A semiquantitative ELISA was used to detect IgG against SARS-CoV-2 in serum (Euroimmun) at 10 time points. In seropositive samples, neutralising antibodies were measured using a virus neutralisation test. Real-time reverse transcription PCR (RT-qPCR) was performed to detect SARS-CoV-2 on nasopharyngeal swabs. Participant characteristics and the presence of symptoms were collected via an online questionnaire.

Results

Among all participants, 80% were women, 60% nurses and 21% physicians. Median age was 40 years. The seroprevalence remained relatively stable from April (7.7% (95% CI: 4.8% to 12.1%) to September (8.2% (95% CI: 5.7% to 11.6%)) and increased thereafter, reaching 19.7% (95% CI: 12.0% to 30.6%) in December 2020. 76 of 778 initially seronegative participants seroconverted during the follow-up (incidence: 205/1000 person-years). Among all seropositive individuals, 118/148 (80%) had a positive neutralisation test, 83/147 (56%) presented or reported a positive RT-qPCR, and 130/147 (88%) reported COVID-19-compatible symptoms at least once. However, only 46/73 (63%) of the seroconverters presented COVID-19-compatible symptoms in the month prior to seroconversion.

Conclusions

The seroprevalence among hospital HCW was slightly higher than that of the general Belgian population but followed a similar evolution, suggesting that infection prevention and control measures were effective and should be strictly maintained. After two SARS-CoV-2 waves, 80% of HCW remained seronegative, justifying their prioritisation in the vaccination strategy.

Trial registration number

NCT04373889
Burnout in physicians: a survey of the Danish society for palliative medicine
Authors: Boegelund Kristensen Tina , Kelstrup Hallas Mette , Høgsted Rikke , Groenvold Mogens , Sjøgren Per , Marsaa Kristoffer
Published: June 2021

Objectives

Burnout, which is a state of prolonged physical and psychological exhaustion, seems to be a prevalent and serious problem among healthcare workers. Our aim was to investigate the prevalence of burnout symptoms among members of Danish Society of Palliative Medicine (DSPaM).

Methods

All 160 physician members of DSPaM were invited to a questionnaire survey. The Copenhagen Burnout Inventory (CBI) was used to evaluate and differentiate between personal, work-related and client-related burnout.

Results

76 members responded (47,5%). 51% regularly received supervision. Scores on personal burnout demonstrated that 25% had no symptoms and 55% had symptoms that required attention; however, no respondents needed immediate intervention. Regarding work-related burnout: 40% had no symptoms, 20% had symptoms that needed attention and 3% needed immediate help. Regarding client-related burnout: 65% had no symptoms, 32% had symptoms that needed attention and none needed immediate intervention.

Conclusions

This survey demonstrated a relatively low rate of burnout symptoms among members of the DSPaM. In particular, the client-related burnout score was low, while higher scores were observed in personal and work-related burnout. Despite the relatively low overall levels of burnout, it is notable that about half of the physicians reported personal burnout, which needs to be addressed.
Perspectives of obstetricians and midwives on the provision of immediate postpartum intrauterine devices: a qualitative service evaluation
Authors: Boydell Nicola , Cooper Michelle , Cameron Sharon T , Glasier Anna , Coutts Shiona , McGuire Frances , Harden Jeni
Published: June 2021

Background

Immediate postpartum intrauterine device (PPIUD) insertion is safe and effective but largely unavailable in Europe. Data on maternity staff views on the provision and implementation of PPIUD services are limited. The objective of this qualitative evaluation was to explore the views and experiences of obstetricians and midwives providing PPIUD within a UK maternity setting, in order to identify areas for improvement and inform service provision in other areas.

Methods

Qualitative health services research within two public maternity hospitals in Lothian (Edinburgh and surrounding region), UK. Interviews with 30 maternity staff (obstetricians n=8; midwives n=22) involved in PPIUD provision. Data were analysed thematically.

Results

Maternity staff were positive about the benefits of PPIUD for women. Midwives reported initial concerns about PPIUD safety, and the impact on workload; these views shifted following training, and as PPIUD was embedded into practice. Having a large pool of PPIUD-trained staff was identified as an important factor in successful service implementation. Having PPIUD ‘champions’ was important to address staff concerns, encourage training uptake, and advocate for the service to ensure continued resourcing.

Conclusions

PPIUD in maternity services can help address unmet need for effective contraception in the immediate postpartum period. We emphasise the importance of widespread engagement around PPIUD among all healthcare professionals involved in the care of women, to ensure staff are informed and supported. Clinical champions and leaders play a key role in amplifying the benefits of PPIUD, and advancing organisational learning.
Delay in Transit: selected recommendations from the NCEPOD report on acute bowel obstruction
Authors: Sinclair Martin , Culkin Alison , Douds Andrew C , Michalski Antony , Shotton Hannah
Published: June 2021

Delayed in Transit, the report of the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) on acute bowel obstruction (ABO), highlighted a number of areas for improvement in this group of patients. The overarching finding was that there were delays in the pathway of care for patients with ABO at every stage of the clinical pathway, including diagnosis, decision-making and the availability of operating theatres. Furthermore, basic measures including hydration, nutritional screening and nutritional assessment were noted to be deficient. Patients who were admitted to non-surgical wards had an increased risk of delayed treatment and subsequently a longer starvation period. There was room for improvement of nutritional screening and assessment on admission, throughout the hospital stay and on discharge. A selection of the report recommendations that address these areas requiring improvement is discussed here.
Multitrait genetic association analysis identifies 50 new risk loci for gastro-oesophageal reflux, seven new loci for Barrett’s oesophagus and provides insights into clinical heterogeneity in reflux diagnosis
Authors: Ong Jue-Sheng , An Jiyuan , Han Xikun , Law Matthew H , Nandakumar Priyanka ,   23andMe Research team,   Esophageal cancer consortium, Schumacher Johannes , Gockel Ines , Bohmer Anne , Jankowski Janusz , Palles Claire , Olsen Catherine M , Neale Rachel E , Fitzgerald Rebecca , Thrift Aaron P , Vaughan Thomas L , Buas Matthew F , Hinds David A , Gharahkhani Puya , Kendall Bradley J , MacGregor Stuart
Published: June 2021

Objective

Gastro-oesophageal reflux disease (GERD) has heterogeneous aetiology primarily attributable to its symptom-based definitions. GERD genome-wide association studies (GWASs) have shown strong genetic overlaps with established risk factors such as obesity and depression. We hypothesised that the shared genetic architecture between GERD and these risk factors can be leveraged to (1) identify new GERD and Barrett’s oesophagus (BE) risk loci and (2) explore potentially heterogeneous pathways leading to GERD and oesophageal complications.

Design

We applied multitrait GWAS models combining GERD (78 707 cases; 288 734 controls) and genetically correlated traits including education attainment, depression and body mass index. We also used multitrait analysis to identify BE risk loci. Top hits were replicated in 23andMe (462 753 GERD cases, 24 099 BE cases, 1 484 025 controls). We additionally dissected the GERD loci into obesity-driven and depression-driven subgroups. These subgroups were investigated to determine how they relate to tissue-specific gene expression and to risk of serious oesophageal disease (BE and/or oesophageal adenocarcinoma, EA).

Results

We identified 88 loci associated with GERD, with 59 replicating in 23andMe after multiple testing corrections. Our BE analysis identified seven novel loci. Additionally we showed that only the obesity-driven GERD loci (but not the depression-driven loci) were associated with genes enriched in oesophageal tissues and successfully predicted BE/EA.

Conclusion

Our multitrait model identified many novel risk loci for GERD and BE. We present strong evidence for a genetic underpinning of disease heterogeneity in GERD and show that GERD loci associated with depressive symptoms are not strong predictors of BE/EA relative to obesity-driven GERD loci.
Artificial intelligence and colonoscopy experience: lessons from two randomised trials
Authors: Repici Alessandro , Spadaccini Marco , Antonelli Giulio , Correale Loredana , Maselli Roberta , Galtieri Piera Alessia , Pellegatta Gaia , Capogreco Antonio , Milluzzo Sebastian Manuel , Lollo Gianluca , Di Paolo Dhanai , Badalamenti Matteo , Ferrara Elisa , Fugazza Alessandro , Carrara Silvia , Anderloni Andrea , Rondonotti Emanuele , Amato Arnaldo , De Gottardi Andrea , Spada Cristiano , Radaelli Franco , Savevski Victor , Wallace Michael B , Sharma Prateek , Rösch Thomas , Hassan Cesare
Published: June 2021

Background and aims

Artificial intelligence has been shown to increase adenoma detection rate (ADR) as the main surrogate outcome parameter of colonoscopy quality. To which extent this effect may be related to physician experience is not known. We performed a randomised trial with colonoscopists in their qualification period (AID-2) and compared these data with a previously published randomised trial in expert endoscopists (AID-1).

Methods

In this prospective, randomised controlled non-inferiority trial (AID-2), 10 non-expert endoscopists (<2000 colonoscopies) performed screening/surveillance/diagnostic colonoscopies in consecutive 40–80 year-old subjects using high-definition colonoscopy with or without a real-time deep-learning computer-aided detection (CADe) (GI Genius, Medtronic). The primary outcome was ADR in both groups with histology of resected lesions as reference. In a post-hoc analysis, data from this randomised controlled trial (RCT) were compared with data from the previous AID-1 RCT involving six experienced endoscopists in an otherwise similar setting.

Results

In 660 patients (62.3±10 years; men/women: 330/330) with equal distribution of study parameters, overall ADR was higher in the CADe than in the control group (53.3% vs 44.5%; relative risk (RR): 1.22; 95% CI: 1.04 to 1.40; p<0.01 for non-inferiority and p=0.02 for superiority). Similar increases were seen in adenoma numbers per colonoscopy and in small and distal lesions. No differences were observed with regards to detection of non-neoplastic lesions. When pooling these data with those from the AID-1 study, use of CADe (RR 1.29; 95% CI: 1.16 to 1.42) and colonoscopy indication, but not the level of examiner experience (RR 1.02; 95% CI: 0.89 to 1.16) were associated with ADR differences in a multivariate analysis.

Conclusions

In less experienced examiners, CADe assistance during colonoscopy increased ADR and a number of related polyp parameters as compared with the control group. Experience appears to play a minor role as determining factor for ADR.

Trial registration number

NCT:04260321.
Efficacy and mid-term outcome of middle meningeal artery embolization with or without burr hole evacuation for chronic subdural hematoma compared with burr hole evacuation alone
Authors: Onyinzo Christina , Berlis Ansgar , Abel Maria , Kudernatsch Manfred , Maurer Christoph J
Published: June 2021

Background

Chronic subdural hematoma (CSDH) is a common neurosurgical condition with high recurrence rates. Repeated microbleedings from fragile neo-vessels supplied by peripheral branches of the middle meningeal artery (MMA) are believed to be responsible for the growth and recurrence of CSDH. Thus, MMA embolization might be a promising method to prevent re-bleedings and recurrences. This study aims to assess the efficacy, complication rates, and mid-term outcome of MMA embolization with or without burr hole irrigation compared with burr hole irrigation alone.

Methods

Patients diagnosed with CSDH who underwent MMA embolization and/or surgical treatment were retrospectively recruited to this single-center study. The outcome variables were defined as treatment-related complications, clinical outcome at discharge, rate of revision surgery, and CT findings during the follow-up period.

Results

A total of 132 patients with CSDH were included in the study. The use of antiplatelet/anticoagulant medication was significantly higher in the combined treatment and embolization group (p<0.001). A trend towards fewer revision surgeries was found in the group of patients who received MMA embolization combined with burr hole irrigation (p=0.083). Follow-up was available for 73 patients (55.3%) with a mean follow-up period of 3.4±2.2 months. Eight patients (15.1%) of the surgery group showed hematoma re-accumulation and needed surgical rescue, whereas only one patient (5.0%) of the combined treatment group needed revision surgery. In all patients treated with only MMA embolization, complete hematoma resolution was found.

Conclusion

MMA embolization is a safe and efficacious minimal invasive adjuvant and/or alternative procedure for the treatment of CSDH with a reduced recurrence rate.
SMEFT analysis of vector boson scattering and diboson data from the LHC Run II
Authors: Ethier Jacob J. , Gomez-Ambrosio Raquel , Magni Giacomo , Rojo Juan
Published: June 2021

We present a systematic interpretation of vector boson scattering (VBS) and diboson measurements from the LHC in the framework of the dimension-six standard model effective field theory (SMEFT). We consider all available measurements of VBS fiducial cross-sections and differential distributions from ATLAS and CMS, in most cases based on the full Run II luminosity, and use them to constrain 16 independent directions in the dimension-six EFT parameter space. Compared to the diboson measurements, we find that VBS provides complementary information on several of the operators relevant for the description of the electroweak sector. We also quantify the ultimate EFT reach of VBS measurements via dedicated projections for the high luminosity LHC. Our results motivate the integration of VBS processes in future global SMEFT interpretations of particle physics data.
Effective ionization coefficients for low current dc discharges in alcohol vapours at low pressure
Authors: Marjanović Jelena , Marić Dragana , Malović Gordana , Petrović Zoran Lj.
Published: June 2021

This paper presents results for effective ionisation coefficients ($$\alpha _{\mathrm {eff}}/N$$αeff/N,N—gas density) obtained from the breakdown voltage and emission profile measurements in low-pressure dc discharges in vapours of alcohols: methanol, ethanol, isopropanol, and n-butanol. Our results for$$\alpha _{\mathrm {eff}}/N$$αeff/Nare determined from the axial emission profiles in low-current Townsend discharge and lay in the interval of reduced electric fieldE/N(E—electric field,N—gas density), from 1 kTd to 8.8 kTd. We also give a comparison of our experimental results with those from the available literature. Our data cover the highE/Nrange of the standard operating conditions and in the region where other data are available we have a good agreement.

Graphic abstract
Negligibility of haptotaxis effect in a chemotaxis–haptotaxis model
Authors: Jin Hai-Yang , Xiang Tian
Published: June 2021

In this work, we rigorously study chemotaxis effect versus haptotaxis effect on boundedness, blow-up and asymptotical behavior of solutions for a chemotaxis-haptotaxis model in 2D settings. It is well-known that the corresponding Keller–Segel chemotaxis-only model possesses a striking feature of critical mass blowup phenomenon, namely, subcritical mass ensures boundedness, whereas, supercritical mass induces the existence of blow-ups. Herein, we show that this critical mass blow-up phenomenon stays almost the same in the full chemotaxis-haptotaxis model and that any global-in-time haptotaxis solution component vanishes exponentially and the other two solution components converge exponentially to that of chemotaxis-only model in a global sense for suitably large chemo-sensitivity and in the usual sense for suitably small chemo-sensitivity. Therefore, haptotaixs is neither good nor bad than chemotaxis, showing negligibility of haptotaxis effect in the underlying chemotaxis-haptotaxis model.
CuO/SnO2Nanocomposite Thin Films: Effect of Solvent and Precursor on Optical and Structural Properties
Authors: Bellal Youcef , Bouhank Antar
Published: June 2021

New materials nanocomposites were synthesized for the degradation of organic and inorganic pollutants. This study reviews CuO/SnO2nanocomposite thin films for their photocatalytic effect. The latter were deposited using the spray pyrolysis method, which is a simple, cheapest and rapid technique. Different concentration ratios of precursors and solvent are used. The thin films were deposited on ordinary glass substrates heated to 550∘C from solutions of copper chloride and tin chloride as precursors. The optical and structural properties of nanocomposite thin films have been demonstrated, and the equi-percentage of the precursor combination shows the good bandgap energy according to the literature. Investigations of structural properties using (SEM, EDS, XRD and RAMAN) techniques depict the good agreement photocatalytic degradation according to the surface roughness, quantities of elements and the existence of phases which will be of interest to the photocatalytic of organic and inorganic pollutants in aqueous and gas media according to the huge specific area due to the roughness and heterogeneity.
Tumor cell death visualization of renal cell carcinoma under the combined effect of theGratiola officinalisextract and cyclophosphamide using fluorescent staining methods
Authors: Mylnikov Artyom , Navolokin Nikita , Mudrak Dmitry , Polukonova Natalya , Bucharskaya Alla , Maslyakova Galina
Published: June 2021

Objective of the study: We used fluorescence imaging methods of apoptosis and necrosis in human renal carcinoma A498 tumor cells in vitro to reveal the indicated forms of cell death under the combined effect of flavonoid-containing extract of Gratiola officinalis and cytostatic (cyclophosphamide). Materials and methods: The dyes were propidium iodide and acridine orange, which were used in the “alive and dead” test. This test helped us to identify the total number of dead cells in the forms of necrosis and apoptosis and the number of cells in which apoptosis had started, it was characterized by the appearance of apoptotic bodies or nucleus pyknosis. Results: We found the most pronounced cytotoxic activity at the ratio of extract of Gratiola officinalis and cyclophosphamide concentrations of 1:1. The number of living cells decreased when exposed to the ratio of extract and cytostatic concentrations of 2:1. When the ratio of concentration of the extract relative to the cytostatic increased to 3:1, the cytostatic activity of the extract began to appear, the total number of tumor cells decreased. The number of cells with nucleus pyknosis and the number of cells with apoptosis signs significantly increased at a 3:1 ratio of extract and cytostatic concentrations, which confirms the presence of pro-apoptotic activity of the studied combination. This trend indicates the dependence of a certain form of cell death (apoptosis, necrosis) on the ratio of extract and cytostatic doses, and it also demonstrates the cytostatic and cytotoxic effects of this combination. Conclusion: Fluorescence methods of investigation in the “alive and dead” test allowed us to visualize the forms of cell death of human kidney carcinoma A498 by combined exposure to the flavonoid-containing extract of Gratiola officinalis and cytostatic (cyclophosphamide) 24 h after exposure. We found that the combination with a concentration ratio of the extract and cyclophosphamide of 3:1 has the greatest effectiveness due to stimulation of the cytostatic effect and cytotoxic effect.
HOW MUCH COULD ARTICLE 6 ENHANCE NATIONALLY DETERMINED CONTRIBUTION AMBITION TOWARD PARIS AGREEMENT GOALS THROUGH ECONOMIC EFFICIENCY?
Authors: EDMONDS JAMES , YU SHA , MCJEON HAEWON , FORRISTER DIRK , ALDY JOSEPH , HULTMAN NATHAN , CUI RYNA , WALDHOFF STEPHANIE , CLARKE LEON , CLARA STEFANO DE , MUNNINGS CLAYTON
Published: June 2021

The Paris Agreement of 2015 uses Nationally Determined Contributions (NDCs) to achieve its goal to limit climate change to well below 2°C. Article 6 allows countries to cooperatively implement NDCs provided they do not double-count mitigation. We estimate that economic efficiency gains from cooperative implementation of existing NDC goals using Article 6 could reduce the cost of achieving NDC goals in 2030 to all parties by [Formula: see text]$[Formula: see text], which if reinvested in additional emissions mitigation could add 9 billion tons CO2/year mitigation, beyond the 8 billion tons CO2/year currently pledged in 2030. We estimate that more than half of the 2030 gains could come from nature-based measures, but long-term potential for nature-based measures is more limited. How much or even if this economic potential can be realized is uncertain and will depend on both the rules and their implementation.
Machine learning-based prediction of the translaminar R-curve of composites from simple tensile test of pre-cracked samples
Authors: Qiu Cheng , Han Yuzi , Shanmugam Logesh , Guan Zhidong , Zhang Zhong , Du Shanyi , Yang Jinglei
Published: June 2021

A novel approach to determine the translaminar crack resistance curve of composite laminates by means of a machine learning model is presented in this paper. The main objective of the proposed method is to extract hidden information of crack resistance from strength values of center-cracked laminates. Compared to traditional measurements, the notable advantage is that only tensile strength values are required which can be obtained by a rather simpler experimental procedure. This is achieved by the incorporation of the finite fracture mechanics, which links crack resistance with strength values. In order to get training dataset, a semi-analytical method using both finite element method and finite fracture mechanics is employed to generate strength values of center-cracked specimens with different random R-curves, which serve as inputs for our artificial neural network. Regarding the outputs, principal component analysis is performed to reduce dimensionality and find suitable descriptors for crack resistance curves. After successfully training machine learning model, experimental studies on basalt fiber reinforced laminates are conducted as validation. Results have proven the effectiveness of the proposed strategy for predicting crack resistance curves, as well as the feasibility of using machine learning-based framework to find out more information about composites from simple experimental data.