bluuebunny/crossref_metadata_2025 huggingface dataset:
Category Clustering and Morphological Learning
Authors: Mansfield John , Saldana Carmen , Hurst Peter , Nordlinger Rachel , Stoll Sabine , Bickel Balthasar , Perfors Andrew
Published: February 2022

Inflectional affixes expressing the same grammatical category (e.g., subject agreement) tend to appear in the same morphological position in the word. We hypothesize that this cross‐linguistic tendency towardcategory clusteringis at least partly the result of a learning bias, which facilitates the transmission of morphology from one generation to the next if each inflectional category has a consistent morphological position. We test this in an online artificial language experiment, teaching adult English speakers a miniature language consisting of noun stems representing shapes and suffixes representing the color and number features of each shape. In one experimental condition, each suffix category has a fixed position, with color in the first position and number in the second position. In a second condition, each specific combination of suffixes has a fixed order, but some combinations have color in the first position, and some have number in the first position. In a third condition, suffixes are randomly ordered on each presentation. While the language in the first condition is consistent with the category clustering principle, those in the other conditions are not. Our results indicate that category clustering of inflectional affixes facilitates morphological learning, at least in adult English speakers. Moreover, we found that languages that violate category clustering but still follow fixed affix ordering patterns are more learnable than languages with random ordering. Altogether, our results provide evidence for individual biases toward category clustering; we suggest that this bias may play a causal role in shaping the typological regularities in affix order we find in natural language.
Effect of mitochondrial‐targeted antioxidants on glycaemic control, cardiovascular health, and oxidative stress in humans: A systematic review and meta‐analysis of randomized controlled trials
Authors: Mason Shaun Andrew , Wadley Glenn David , Keske Michelle Anne , Parker Lewan
Published: February 2022

Aim

To investigate the effects of mitochondrial‐targeted antioxidants (mitoAOXs) on glycaemic control, cardiovascular health, and oxidative stress outcomes in humans.

Materials and Methods

Randomized controlled trials investigating mitoAOX interventions in humans were searched for in databases (MEDLINE‐PubMed, Scopus, EMBASE and Cochrane Library) and clinical trial registries up to 10 June 2021. The Cochrane Collaboration's tool for assessing risk of bias and Grading of Recommendations, Assessment, Development and Evaluations were used to assess trial quality and evidence certainty, respectively.

Results

Nineteen studies (n = 884 participants) using mitoAOXs (including Elamipretide, MitoQ and MitoTEMPO) were included in the systematic review. There were limited studies investigating the effects of mitoAOXs on glycaemic control; and outcomes and population groups in studies focusing on cardiovascular health were diverse. MitoAOXs significantly improved brachial flow‐mediated dilation (n = 3 trials; standardized mean difference: 1.19, 95% CI: 0.28, 2.16; I2: 67%) with very low evidence certainty. No significant effects were found for any other glycaemic, cardiovascular or oxidative stress‐related outcomes with mitoAOXs in quantitative analyses, with evidence certainty rated mostly as low. There was a lack of serious treatment‐emergent adverse events with mitoAOXs, although subcutaneous injection of Elamipretide increased mild–moderate injection site‐related events.

Conclusion

While short‐term studies indicate that mitoAOXs are generally well tolerated, there is currently limited evidence to support the use of mitoAOXs in the management of glycaemic control and cardiovascular health. Review findings suggest that future research should focus on the effects of mitoAOXs on glycaemic control and endothelial function in target clinical population groups.
Surgical outcome of temporal plus epilepsy is improved by multilobar resection
Authors: Barba Carmen , Rheims Sylvain , Minotti Lorella , Grisotto Laura , Chabardès Stéphan , Guenot Marc , Isnard Jean , Pellacani Simona , Hermier Marc , Ryvlin Philippe , Kahane Philippe
Published: February 2022

Objective

Temporal plus epilepsy (TPE) represents a rare type of epilepsy characterized by a complex epileptogenic zone including the temporal lobe and the close neighboring structures. We investigated whether the complete resection of temporal plus epileptogenic zone as defined through stereoelectroencephalography (SEEG) might improve seizure outcome in 38 patients with TPE.

Methods

Inclusion criteria were as follows: epilepsy surgery performed between January 1990 and December 2001, SEEG defining a temporal plus epileptogenic zone, unilobar temporal operations (“temporal lobe epilepsy [TLE] surgery”) or multilobar interventions including the temporal lobe (“TPE surgery”), magnetic resonance imaging either normal or showing signs of hippocampal sclerosis, and postoperative follow‐up of at least 12 months. For each assessment of postoperative seizure outcome, at 1, 2, 5, and 10 years, we carried out descriptive analysis and classical tests of hypothesis, namely, Pearson χ2test or Fisher exact test of independence on tables of frequency for each categorical variable of interest and Studentt‐test for each continuous variable of interest, when appropriate.

Results

Twenty‐one patients underwent TPE surgery and 17 underwent TLE surgery with a follow‐up of 12.4 ± 8.16 years. In the multivariate models, there was a significant effect of the time from surgery on Engel Class IA versus IB–IV outcome, with a steadily worsening trend from 5‐year follow‐up onward. TPE surgery was associated with better results than TLE surgery.

Significance

This study suggests that surgical outcome in patients with TPE can be improved by a tailored, multilobar resection and confirms that SEEG is mandatory when a TPE is suspected.
Genetic assignment of fisheries bycatch reveals disproportionate mortality among Alaska Northern Fulmar breeding colonies
Authors: Baetscher Diana S. , Beck Jessie , Anderson Eric C. , Ruegg Kristen , Ramey Andrew M. , Hatch Scott , Nevins Hannah , Fitzgerald Shannon M. , Carlos Garza John
Published: February 2022

Global fisheries kill millions of seabirds annually through bycatch, but little is known about population‐level impacts, particularly in species that form metapopulations. U.S. North Pacific groundfish fisheries catch thousands of Northern Fulmars (Fulmarus glacialis rodgersii) each year, making fulmars the most frequently caught seabird in federally managed U.S. fisheries. Here, we used genetic stock identification to assign 1,536 fulmars sampled as bycatch to one of four Alaska breeding colonies and quantified the similarity of bycatch locations at sea among colonies. We found disproportionately high bycatch from the Pribilof Islands (6% of metapopulation, 23% of bycatch), and disproportionately low bycatch from Chagulak Island (34% of metapopulation, 14% of bycatch). Overlap between fisheries and colony‐specific foraging areas diverge more during the summer breeding season, leading to greater differences in bycatch susceptibility. Contemporary and historical gene flow likely contributes to low genetic differentiation among colonies (FST = 0.003–0.01), yet these values may not represent present connectivity. Our findings illustrate how genetic stock identification can link at‐sea threats to colonies and inform management to reduce bycatch from impacted colonies.
Fermentation reduced the in vitro glycemic index values of probiotic‐rich bean powders
Authors: Tao Li , Song Shixin , Liu Chang , Huang Wanru , Bi Yunfeng , Yu Lei
Published: February 2022

The effects of fermentation on the in vitro estimated glycemic index (eGI) values of probiotic‐rich bean powders were investigated. The main nutrients in the probiotic‐rich bean powders after fermentation were not significantly reduced. The results showed that fermentation led to the reduction of the eGI values of bean powder in experiments with in vitro digestion. It was considered to correlate positively with the increase of resistant starch percentage, the decrease of the starch hydrolysis index, the inhibition of α‐amylase and α‐glucosidase activities, the increase of the phenolic compounds, and the enhancement of the total antioxidant capacity in bean powders after fermentation. That was beneficial to human health.
Enhanced thermal stability of soy protein particles by a combined treatment of microfluidic homogenisation and preheating
Authors: Ren Chao , Zheng Xiaohan , Zou Bowen , Wang Jiamei , Xu Xianbing , Wu Chao , Du Ming
Published: February 2022

Recently, the pursuit of having a healthy diet has heightened the superiority of protein‐enriched beverages; however, this is challenged by the heat‐induced aggregation and gelation of proteins at high concentration. In this study, a facile and efficient strategy of combined preheating and microfluidic homogenisation treatment (CPMHT) was tested to enhance the heat stability of soy proteins (SPs). Results revealed that the CPMHT promoted the denaturation and unfolding of SPs, evidenced by the reduction of β‐sheet content and a slight red shift of fluorescence intensity. Increasing the number of CPMHT cycle led to an apparent decrease in the surface hydrophobicity and total sulfhydryl groups of soy proteins. In addition, when the suspensions (10% (w/v)) of modified soy proteins at higher CPMHT cycle were reheated at 100 °C for 30 min, no gelation was found, along with lower viscosities and higher flow behaviour index. The present study provides an approaching to enhance the heat stability of soy proteins by CPMHT, which might expand the application of soy proteins in protein‐enriched beverages.
Learning to love the null
Authors: Schuengel Carlo
Published: February 2022

Children’s behaviour and mental health has the power to surprise us, readers and authors of the Journal of Child Psychology and Psychiatry and laymen alike, if not for the endless variation among people, then for the ever‐changing context in which they develop. The hypothetico‐deductive method in combination with null‐hypothesis significance testing has turned surprise into scientific knowledge. Null effects may in themselves also be surprising and informative, but appear less well represented in the literature. This editorial highlights emerging methodological practices for studying null effects in the most informative way.
New‐onset fulminant type 1 diabetes after severe acute respiratory syndrome coronavirus 2 vaccination: A case report
Authors: Sasaki Keyaki , Morioka Tomoaki , Okada Natsumi , Natsuki Yuka , Kakutani Yoshinori , Ochi Akinobu , Yamazaki Yuko , Shoji Tetsuo , Ohmura Takashi , Emoto Masanori
Published: February 2022

Fulminant type 1 diabetes is characterized by a rapid progression of insulin deficiency triggered by viral infection. Here, we report a case of a 45‐year‐old Japanese woman with fulminant type 1 diabetes that developed 8 days after receiving messenger ribonucleic acid vaccine against severe acute respiratory syndrome coronavirus 2. She had been healthy and had no symptoms suggestive of viral infection before the vaccination. Laboratory tests showed exhaustion of insulin secretion and negative results for islet autoantibodies. Human leukocyte antigen genotype analysis showed the DRB1*04:05 and DQB1*04:01 alleles. This is the first case report of new‐onset fulminant type 1 diabetes after severe acute respiratory syndrome coronavirus 2 vaccination, and suggests that a severe acute respiratory syndrome coronavirus 2 vaccine might trigger the onset of fulminant type 1 diabetes in susceptible individuals. However, a causal relationship remains to be identified, and further studies are required to determine the incidence of such cases.
Worry about COVID‐19 as a predictor of future insomnia
Authors: Brown Lily A. , Hamlett Gabriella E. , Zhu Yiqin , Wiley Joshua F. , Moore Tyler M. , DiDomenico Grace E. , Visoki Elina , Greenberg David M. , Gur Ruben C. , Gur Raquel E. , Barzilay Ran
Published: February 2022

The coronavirus disease 2019 (COVID‐19) pandemic resulted in significant increases in insomnia, with up to 60% of people reporting increased insomnia. However, it is unclear whether exposure to risk factors for the virus or worries about COVID‐19 are more strongly associated with insomnia. Using a three‐part survey over the course of the first 6 months of the pandemic, we evaluated associations between COVID‐19 exposures, COVID‐19 worries, and insomnia. We hypothesised that COVID‐19‐related worries and exposure to risk of COVID‐19 would predict increases in insomnia. Participants (N = 3,560) completed a survey at three time‐points indicating their exposures to COVID‐19 risk factors, COVID‐19‐related worries, and insomnia. COVID‐19 worry variables were consistently associated with greater insomnia severity, whereas COVID‐19 exposure variables were not. COVID‐19 worries decreased significantly over time, and there were significant interactions between change in COVID‐19 worries and change in insomnia severity over time. Individuals who experienced increases in COVID‐19 worries also experienced increases in insomnia severity. Changes in worry during the COVID‐19 pandemic were associated with changes in insomnia; worries about COVID‐19 were a more consistent predictor of insomnia than COVID‐19 exposures. Evidence‐based treatments targeting virus‐related worries may improve insomnia during this and future calamities.
Examining Deductive Versus Guided Instruction From an Interactionist Perspective
Authors: Azkarai Agurtzane , Oliver Rhonda , Gil‐Berrio Yohana
Published: February 2022

The interactionist hypothesis holds that conversational interaction facilitates second language (L2) learning by providing learners opportunities to receive meaningful input, modify their output, and attend to language form. Although research has often explored the efficacy of different types of L2 instruction (deductive or inductive), few studies have done so from an interactionist perspective. This study explores small‐group interactions of 19 L2 Spanish learners from two intact high school classes as they completed four communicative tasks following either deductive or PACE instruction on the pronoun se. We examined the nature of the student group interactions in each class, focusing on negotiation of meaning (NoM) strategies and language‐related episodes (LREs). The deductive participants used more NoM strategies, and produced more LREs than PACE participants. Regardless of the type of instruction, the majority of LREs dealt with vocabulary and were resolved correctly. Task conditions also mediated the outcomes of feedback and LREs.
A data‐free, support vector machine‐based physics‐driven estimator for dynamic response computation
Authors: Luo Huan , Paal Stephanie German
Published: February 2022

Direct integration methods are widely used for dynamic response computation. However, the performance of their computational accuracy significantly degrades with increasing the time step. Although machine learning methods can address this shortcoming, they require training data for dynamic response computation. This paper proposes a novel computational method to overcome these shortcomings. The proposed approach is a data‐free physics‐driven estimator, which minimizes the objective function of multi‐output least squares support vector machines for regression to model parameters subject to physical constraints introduced by the multi‐degree of freedom system's dynamic equilibrium equations and initial conditions in the feature space, bypassing the need for training data (due to the coupled physics) and for satisfying the requirement of the time step due to the built‐in optimization procedure. A new efficient step‐by‐step solver is developed to solve the optimization problem, and the solution is equivalent to a hyperplane satisfying the physical constraints in the feature space. The extension of the proposed approach for nonlinear dynamic response computation is also analyzed theoretically. The numerical results demonstrate that the proposed approach provides the solution with higher accuracy and efficiency and achieves the best performance for large time steps over classical integration methods.
CsMYB1 integrates the regulation of trichome development and catechins biosynthesis in tea plant domestication
Authors: Li Penghui , Fu Jiamin , Xu Yujie , Shen Yihua , Zhang Yanrui , Ye Zhili , Tong Wei , Zeng Xiangsheng , Yang Jihong , Tang Dingkun , Li Ping , Zuo Hao , Wu Qiong , Xia Enhua , Wang Shucai , Zhao Jian
Published: February 2022

Tea trichomes synthesize numerous specialized metabolites to protect plants from environmental stresses and contribute to tea flavours, but little is known about the regulation of trichome development.

Here, we showed that CsMYB1 is involved in the regulation of trichome formation and galloylated cis‐catechins biosynthesis in tea plants. The variations in CsMYB1 expression levels are closely correlated with trichome indexes and galloylated cis‐catechins contents in tea plant populations. Genome resequencing showed that CsMYB1 may be selected in modern tea cultivars, since a 192‐bp insertion in CsMYB1 promoter was found exclusively in modern tea cultivars but not in the glabrous wild tea Camellia taliensis. Several enhancers in the 192‐bp insertion increased CsMYB1 transcription in modern tea cultivars that coincided with their higher galloylated cis‐catechins contents and trichome indexes.

Biochemical analyses and transgenic data showed that CsMYB1 interacted with CsGL3 and CsWD40 and formed a MYB‐bHLH‐WD40 (MBW) transcriptional complex to activate the trichome regulator genes CsGL2 and CsCPC, and the galloylated cis‐catechins biosynthesis genes anthocyanidin reductase and serine carboxypeptidase‐like 1A. CsMYB1 integratively regulated trichome formation and galloylated cis‐catechins biosynthesis.

Results suggest that CsMYB1, trichome and galloylated cis‐catechins are coincidently selected during tea domestication by harsh environments for improved adaption and by breeders for better tea flavours.
Role of information and preparation for improvement of pediatric perioperative care
Authors: Lööf Gunilla , Lönnqvist Per‐Arne
Published: February 2022

The perioperative period is a significant and stressful experience that may cause negative consequences in children, both in a short‐term and long‐term perspective. Despite a wide base of evidence stating the importance of adequate preparation to reduce anxiety, improve coping, cooperation and enhance recovery, many children continue to report that they feel unprepared for their perioperative experience. To secure children's right to request and need for preparation, the content, format, and availability of existing programs need to be scrutinized. Preparation programs in perioperative care must change from simply providing information to embracing the importance of children's need to process the information provided in order to learn and understand. Interactive web‐based technology can function as a significant resource for preparation of children for perioperative procedures. By changing perspective from children's need for information to their need for learning and by developing preparation programs including adequate educational principles, web‐based technology can be used to its fullest advantage as a healthcare learning and preparation resource.
Beyond The God Gap: Mapping Religiopolitical Heterogeneity in the United States1
Authors: Smith Jesse
Published: February 2022

Research has consistently found that the link between religious and political identification and behavior in the United States has grown significantly, as religious populations have increasingly aligned with the political right while secular Americans move toward the political left. Yet, other research cautions that most Americans are not extreme either politically or religiously. In this study I seek to integrate these claims by applying a latent class analysis to religious and political indicators from the 2016 American National Election Study. Results show six distinct profiles of religiopolitical orientation. Two of these profiles partially correspond to a religious conservative versus secular liberal binary but differ in key characteristics such as size and style of political engagement, exhibiting a dynamic of what I describe as asymmetric polarization. The remainder of the population exhibits religiopolitical orientations that fit with neither extreme. Instead, they fall into one of four internally coherent groups: (1) Religious but apolitical, (2) religious and political but ideologically diverse, (3) nonreligious and apolitical, and (4) nominally religious but behaviorally disengaged from both domains. Rather than polarization or moderation and incoherence, the relationship between religion and politics in the United States may be usefully described in terms of structured heterogeneity.
Large number placements on a bounded number line: The importance of explanations
Authors: Harkness Shelly Sheats , Brass Amy
Published: February 2022

Understanding large number data is essential for making sense of real‐world problems. For the research reported here, our intent was to find connections between quantitative cognitive science studies and our prior qualitative study about participants' understanding of the relative size of large numbers. While all 23 cognitive science research studies that we reviewed focused only on participants' placements of large numbers on number lines, our study focused on preservice teachers' (PSTs; n = 128) strategies – placements and explanations for their placements – of one billion on a number line bounded by zero and one trillion. Our intent was to answer the following question: What are the connections between three plausible placements substantiated by cognitive scientists – linear; log‐linear; and segmented linear – of large numbers on number line tasks and the nine strategies identified in our qualitative study? We highlight exemplars from the nine PSTs' strategies to show connections between the three plausible placements. In doing so, we illustrate that asking participants to place large numbers on number lines only gives a partial picture of their understanding. Their explanations expand the placements by revealing inconsistencies among the placements and explanations. Implications for future research are also discussed.
Caracterización de los vínculos en la organización informal de una Institución de Educación Superior
Authors: Mena De la cruz Aura María , García Vargas Óscar Humberto , Zapata Domínguez Álvaro
Published: February 2022

Este artículo se propone caracterizar los vínculos en la organización informal identificada en tres dependencias de una Institución de Educación Superior de la región Caribe colombiana. El marco referencial comprende los conceptos sobre la organización informal y su estructura (integral, periférico, enlace, near-isolate, isolate). Se utilizó un enfoque metodológico de tipo descriptivo y se recolectaron 40 cuestionarios sociométrico válidos (datos mixtos). Los resultados muestran que los vínculos que sustentan estas relaciones informales en los grupos enfatizan en la convergencia de los valores personales que se comparten (por ejemplo, responsabilidad, honestidad, sinceridad); de igual manera, las caracterizaciones de los individuos enfatizan en cualidades (por ejemplo, amabilidad, colaboración, confiabilidad) como aspectos relevantes para la afiliación en relaciones informales en ellos.
Empoderamiento femenino, emprendimiento y pobreza. El caso colombiano
Authors: Finke Jennifer , Osorio-Tinoco Fabian , Pereira Laverde Fernando
Published: February 2022

Este artículo explora diferentes dimensiones del empoderamiento de las mujeres, que pueden desarrollarse durante el proceso emprendedor. Se evidencian cambios en las dimensiones conforme las mujeres avanzan en el desarrollo de sus emprendimientos, diferenciando características según el contexto (urbano o rural). Adicionalmente, muestra cuáles factores de empoderamiento son claves para la reducción de la pobreza. Se desarrolla un análisis de correspondencia múltiples y un modelo probit ordenado, con datos del Monitor Global de Emprendimiento (GEM por sus siglas en inglés) para Colombia. Los resultados permiten identificar las necesidades y los recursos disponibles para fortalecer el empoderamiento de las mujeres por medio del emprendimiento, mientras que la relación encontrada entre factores de empoderamiento económicos y los ingresos familiares aporta evidencia sobre la importancia del empoderamiento para la reducción de la pobreza.
The role of glimpses with different energy in speech-in-noise recognition
Authors: Tang Yan
Published: February 2022

Listeners can understand speech in noise by “glimpsing” some of the speech regions less affected by noise. This study investigates the contributions of those spectro-temporal regions, known as glimpses, at different energy levels to speech intelligibility in noise. Two listening experiments were conducted to examine the intelligibility of speech in different glimpse compositions in two types of noise. The results suggest that glimpsed spectro-temporal regions with energy above the mean noise level are the primary cue for speech perception in noise, and that listeners can use less-robust cues until at least 15 dB below the glimpsing threshold.
Arthrogenic Muscle Inhibition Following Anterior Cruciate Ligament Injury
Authors: Pietrosimone Brian , Lepley Adam S. , Kuenze Christopher , Harkey Matthew S. , Hart Joseph M. , Blackburn J. Troy , Norte Grant
Published: February 2022

Arthrogenic muscle inhibition (AMI) is a common impairment in individuals who sustain an anterior cruciate ligament (ACL) injury. The AMI causes decreased muscle activation, which impairs muscle strength, leading to aberrant movement biomechanics. The AMI is often resistant to traditional rehabilitation techniques, which leads to persistent neuromuscular deficits following ACL reconstruction. To better treat AMI following ACL injury and ACL reconstruction, it is important to understand the specific neural pathways involved in AMI pathogenesis, as well as the changes in muscle function that may impact movement biomechanics and long-term structural alterations to joint tissue. Overall, AMI is a critical factor that limits optimal rehabilitation outcomes following ACL injury and ACL reconstruction. This review discusses the current understanding of the: (1) neural pathways involved in the AMI pathogenesis following ACL injury; (2) consequence of AMI on muscle function, joint biomechanics, and patient function; and (3) development of posttraumatic osteoarthritis. Finally, the authors review the evidence for interventions specifically used to target AMI following ACL injury.
Genome-Wide Characterization of SARS-CoV-2 Cytopathogenic Proteins in the Search of Antiviral Targets
Authors: Zhang Jiantao , Li Qi , Cruz Cosme Ruth S. , Gerzanich Volodymyr , Tang Qiyi , Simard J. Marc , Zhao Richard Y.
Published: February 2022

The ongoing COVID-19 pandemic caused by SARS-CoV-2 has claimed over 5.5 million lives with more than 300 million people infected worldwide. While vaccines are effective, the emergence of new viral variants could jeopardize vaccine protection.
Evolutionary Sweeps of Subviral Parasites and Their Phage Host Bring Unique Parasite Variants and Disappearance of a Phage CRISPR-Cas System
Authors: Angermeyer Angus , Hays Stephanie G. , Nguyen Maria H. T. , Johura Fatema-tuz , Sultana Marzia , Alam Munirul , Seed Kimberley D.
Published: February 2022

With 1 to 4 million estimated cases annually, cholera is a disease of serious global concern in regions where access to safe drinking water is limited by inadequate infrastructure, inequity, or natural disaster. The Global Task Force on Cholera Control (GTFCC.org) considers outbreak surveillance to be a primary pillar in the strategy to reduce mortality from cholera worldwide.
Soil pH Filters the Association Patterns of Aluminum-Tolerant Microorganisms in Rice Paddies
Authors: Zhang Na , Ma Zhiyuan , Li Dong , Ni Haowei , Sun Bo , Liang Yuting
Published: February 2022

Aluminum (Al) toxicity is the primary limiting factor of crop production in acidic soils with pH <5.0. Numerous studies have focused on the mechanism of Al toxicity and tolerance in plants; however, the effects of Al toxicity on soil microorganisms and their tolerance remain less studied.
Supplemental Material: A Tonian volcano-sedimentary succession in Newfoundland, eastern North America: A post-Grenvillian link to the Asgard Sea?
Authors: Strowbridge Susan , al. et
Published: February 2022

U-Pb (LA-ICP-MS) zircon data, analytical methods and grain descriptions.
Supplemental Material: Millennial pulses of ore formation and an extra-high Tibetan Plateau
Authors: Li Yang , al. et
Published: February 2022

Sample information, methods and data.
Bilateral cardiac sympathetic denervation for refractory arrhythmia in an individual with catecholaminergic polymorphic ventricular tachycardia associated with T-cell-mediated ganglionitis
Authors: Carpenter Alexander , Connolly Georgia May , Duncan Edward , Nisbet Ashley
Published: February 2022

The individual in our case was troubled with difficult to control arrhythmia in the context of RYR2-mutation positive catecholaminergic polymorphic ventricular tachycardia (CPVT) despite medication. Recurrent implantable cardioverter defibrillator (ICD) shocks occurred for ventricular tachycardia (VT) and ventricular fibrillation (VF) as well as inappropriate shocks as a result of rapidly conducted atrial fibrillation (AF). Catheter ablation was effective in controlling these episodes of AF. Despite left cardiac sympathetic denervation, episodes of ventricular arrhythmia and subsequent ICD shocks persisted. Contralateral sympathetic cardiac denervation was subsequently undertaken, with histology suggesting T-cell mediated ganglionitis. 18 months on, there have been no further episodes of ventricular arrhythmia.
A case of stromal microsporidiosis: medical strategies employed for successful resolution
Authors: Raghavan Anita , Raja Devi Rosette , Venkatapathy Narendran , Rammohan Ram
Published: February 2022

We describe the diagnosis and successful management of a case of stromal microsporidiosis, an important emerging ocular disease. Stromal microsporidiosis is recalcitrant and very often requires therapeutic keratoplasty for effective eradication. We successfully managed a steroid-treated case diagnosed only after 9 months, with a combination of polyhexamethyl biguanide 0.04%, chlorhexidine 0.04% and fluconazole 0.3% eye drops supplemented with tablet albendazole. However, complete resolution was achieved only after epithelial debridement. Toxicity due to the drugs was not noted. Diagnostic delays, steroid use and inappropriate therapy are commonly observed in stromal microsporidiosis. In spite of these potential disadvantages, our case responded well with complete eradication of the infection. The disease being fairly indolent and slowly progressive, medical therapy should be continued, in the absence of progression or other complications. Epithelial debridement may facilitate healing.
Gender equality and the gender gap in life expectancy in the European Union
Authors: Pinho-Gomes Ana-Catarina , Vassallo Amy , Carcel Cheryl , Peters Sanne , Woodward Mark
Published: February 2022

Introduction

Life expectancy (LE) depends on the wider determinants of health, which have different impact in women and men. Therefore, this study aimed to investigate whether gender equality was correlated with LE in women and men.

Methods

Gender equality in the 27 European Union (EU) member states between 2010 and 2019 was estimated using a modified Gender Equality Index (mGEI), based on the index developed by the European Institute for Gender Equality. The correlation between this mGEI and LE and the gender gap in LE was calculated using the Spearman correlation coefficient.

Results

Between 2010 and 2019, LE increased more for men than women, which resulted in a narrowing of the gender gap in LE in the EU. During the same period, there was an increase in gender equality, as measured by the mGEI, although with substantial heterogeneity between countries. There was a strong correlation between the mGEI and the gender gap in LE (−0.880), which was explained by a stronger correlation between the mGEI and longer LE in men than in women (0.655 vs 0.629, respectively). The domains of the mGEI most strongly associated with a narrowing of the gender gap in LE were health, money and knowledge, while power was the domain with the weakest association.

Conclusions

Gender equality appears to be at least as beneficial to men as women with regard to LE, thus reinforcing the key role gender equality plays in improving population health and longevity.
Knowledge, attitude and practice of community-dwelling adults regarding advance care planning in Malaysia: a cross-sectional study
Authors: Lim Mun Kit , Lai Pauline Siew Mei , Lim Pei Shan , Wong Pei Se , Othman Sajaratulnisah , Mydin Fadzilah Hanum Mohd
Published: February 2022

Objectives

This study aimed to assess the knowledge, attitude and practice (KAP) among community-dwelling adults in Malaysia regarding advance care planning (ACP), and its associated factors.

Design

This cross-sectional study was conducted from July–September 2018.

Setting

This study was conducted at the University Malaya Medical Centre, Kuala Lumpur, Malaysia.

Participants

We recruited community-dwelling adults (ambulatory care patients or their accompanying persons) who were ≥21 years old and able to understand English or Malay. A 1:10 systematic sampling procedure was used. Excluded were community-dwelling adults with intellectual disabilities or non-Malaysian accompanying persons. A trained researcher administered the validated English or Malay Advance Care Planning Questionnaire at baseline and 2 weeks later.

Primary and secondary outcome measures

The primary outcome was the KAP regarding ACP. The secondary outcomes were factors associated with KAP.

Results

A total of 385/393 community-dwelling adults agreed to participate (response rate 98%). Only 3.1% of the community-dwelling adults have heard about ACP and 85.7% of them felt that discussion on ACP was necessary after explanation of the term. The desire to maintain their decision-making ability when seriously ill (94.9%) and reducing family burden (91.6%) were the main motivating factors for ACP. In contrast, resorting to fate (86.5%) and perceived healthy condition (77.0%) were the main reasons against ACP. Overall, 84.4% would consider discussing ACP in the future. Community-dwelling adults who were employed were less likely to know about ACP (OR=0.167, 95% CI 0.050 to 0.559, p=0.004) whereas those with comorbidities were more likely to favour ACP (OR=2.460, 95% CI 1.161 to 5.213, p=0.019). No factor was found to be associated with the practice of ACP.

Conclusions

Despite the lack of awareness regarding ACP, majority of community-dwelling adults in Malaysia had a positive attitude towards ACP and were willing to engage in a discussion regarding ACP after the term ‘ACP’ has been explained to them.
Impact of governmental support to the IVF clinical pregnancy rates: differences between public and private clinical settings in Kazakhstan—a prospective cohort study
Authors: Issanov Alpamys , Aimagambetova Gulzhanat , Terzic Sanja , Bapayeva Gauri , Ukybassova Talshyn , Baikoshkarova Saltanat , Utepova Gulnara , Daribay Zhanibek , Bekbossinova Gulnara , Balykov Askhat , Aldiyarova Aidana , Terzic Milan
Published: February 2022

Objectives

Infertility rates have been increasing in low-income and middle-income countries, including Kazakhstan. The need for accessible and affordable assisted reproductive technologies has become essential for many subfertile women. We aimed to explore whether the public funding and clinical settings are independently associated with in vitro fertilisation (IVF) clinical pregnancy and to determine whether the relationship between IVF clinical pregnancy and clinical settings is modified by payment type.

Design

A prospective cohort study.

Setting

Three private and two public IVF clinics located in major cities.

Participants

Women aged ≥18 seeking first or repeated IVF treatment and agreed to complete a survey were included in the study. Demographical and previous medical history data were collected from a survey, while clinical data from medical records. The total response rate was 14%.

Primary and secondary outcome measures

Clinical pregnancy was defined as a live intrauterine pregnancy identified by ultrasound scan at 8 gestational weeks. The outcome data were missing for 22% of women.

Results

Out of 446 women in the study, 68.2% attended private clinics. Two-thirds of women attending public clinics and 13% of women attending private clinics were publicly funded. Private clinics retrieved, on average, a higher number of oocytes (11.5±8.4 vs 8.1±7.2, p<0.001) and transferred more embryos (2.2±2.5 vs 1.4±1.1, p<0.001) and had a statistically significantly higher pregnancy rate compared with public clinics (79.0% vs 29.7%, p<0.001). Publicly funded women had on average a higher number of oocytes retrieved and a statistically significantly higher probability of clinical pregnancy (RR=1.23, 95% CI 1.02 to 1.47) than self-paid women, after adjusting for covariates. There was no statistically significant interaction between clinical setting and payment type.

Conclusions

Private clinics and public funding were independently associated with higher IVF clinical pregnancy rates. There is also a need to further investigate whether the increase in public funding will influence clinical pregnancy rates.
Relationship between exposure to ozone and exacerbation requiring hospital admission among patients with asthma: a case-control study in central Taiwan
Authors: Lin Ching-Heng , Wong Li-Ting , Hsu Jeng-Yuan , Chao Wen-Cheng
Published: February 2022

Objective

The convergence of asthma and air pollutants in ageing populations is currently a growing health issue worldwide, and hence there is an essential need to investigate the association between exposure to air pollution, particularly ozone (O3), and exacerbation requiring admission in patients with asthma.

Setting

A case-control study at a tertiary referral hospital in central Taiwan.

Participants

We used an asthma cohort, which included 11 400 patients with asthma, for the period 2006–2018 at Taichung Veterans General Hospital.

Primary and secondary outcome measures

We identified patients who had admitted for exacerbation as cases and selected patients with asthma without exacerbation, matching (1:4) the cases for age, gender and season of exacerbation, as controls. Data on hourly level of air pollutants were obtained from the Taiwan Environmental Protection Administration. We used conditional logistic regression and calculated adjusted ORs (adjORs) with 95% CIs.

Results

We enrolled 11 400 participants with asthma, and 4.4% (501) of them had been admitted for exacerbation. Participants with asthma with exacerbation requiring hospitalisation were exposed to a higher level of O3 8-hour daily maximum (adjOR 1.009, 95% CI 1.001 to 1.016) and were more likely to have high Charlson Comorbidity Index (CCI ≥3; adjOR 2.198, 95% CI 1.729 to 2.794) and asthma-chronic obstructive pulmonary disease overlap (adjOR 4.542, 95% CI 3.376 to 6.611) compared with those without exacerbation. The aforementioned associations between exacerbation of asthma requiring hospitalisation and exposure to O3 were similar when defined by either O3 1-hour daily maximum or O3 24-hour average. Moreover, the O3 relevant exacerbation of asthma mainly existed in those aged older than 65 years and patients with medical comorbidities, including gastrointestinal diseases, cardiovascular diseases, neurological diseases, diabetes and renal disease.

Conclusions

Our findings highlight the need for vigilance of exposure to O3 among elderly with asthma, particularly those with medical comorbidities. Further studies are warranted to investigate the underlying mechanisms.
Association between pharmaceutical modulation of oestrogen in postmenopausal women in Sweden and death due to COVID-19: a cohort study
Authors: Sund Malin , Fonseca-Rodríguez Osvaldo , Josefsson Andreas , Welen Karin , Fors Connolly Anne-Marie
Published: February 2022

Objective

Determine whether augmentation of oestrogen in postmenopausal women decreases the risk of death following COVID-19.

Design

Nationwide registry-based study in Sweden based on registries from the Swedish Public Health Agency (all individuals who tested positive for SARS-CoV-2); Statistics Sweden (socioeconomical variables) and the National Board of Health and Welfare (causes of death).

Participants

Postmenopausal women between 50 and 80 years of age with verified COVID-19.

Interventions

Pharmaceutical modulation of oestrogen as defined by (1) women with previously diagnosed breast cancer and receiving endocrine therapy (decreased systemic oestrogen levels); (2) women receiving hormone replacement therapy (increased systemic oestrogen levels) and (3) a control group not fulfilling requirements for group 1 or 2 (postmenopausal oestrogen levels). Adjustments were made for potential confounders such as age, annual disposable income (richest group as the reference category), highest level of education (primary, secondary and tertiary (reference)) and the weighted Charlson Comorbidity Index (wCCI).

Primary outcome measure

Death following COVID-19.

Results

From a nationwide cohort consisting of 49 853 women diagnosed with COVID-19 between 4 February and 14 September 2020 in Sweden, 16 693 were between 50 and 80 years of age. We included 14 685 women in the study with 11 923 (81%) in the control group, 227 (2%) women in group 1 and 2535 (17%) women in group 2. The unadjusted ORs for death following COVID-19 were 2.35 (95% CI 1.51 to 3.65) for group 1 and 0.45 (0.34 to 0.6) for group 2. Only the adjusted OR for death remained significant for group 2 with OR 0.47 (0.34 to 0.63). Absolute risk of death was 4.6% for the control group vs 10.1% and 2.1%, for the decreased and increased oestrogen groups, respectively. The risk of death due to COVID-19 was significantly associated with: age, OR 1.15 (1.14 to 1.17); annual income, poorest 2.79 (1.96 to 3.97), poor 2.43 (91.71 to 3.46) and middle 1.64 (1.11 to 2.41); and education (primary 1.4 (1.07 to 1.81)) and wCCI 1.13 (1.1 to 1.16).

Conclusions

Oestrogen supplementation in postmenopausal women is associated with a decreased risk of dying from COVID-19 in this nationwide cohort study. These findings are limited by the retrospective and non-randomised design. Further randomised intervention trials are warranted.
KETOgenic diet therapy in patients with HEPatocellular adenoma: study protocol of a matched interventional cohort study
Authors: Oudmaijer Christiaan Albert Johan , Berk Kirsten Anna , van der Louw Elisabeth Johanna Theresia Maria , de Man Rob , van der Lelij Aart-Jan , Hoeijmakers Jan Hendrik Jozef , IJzermans Jan
Published: February 2022

Introduction

Hepatocellular adenoma (HCA) is an uncommon, solid and benign liver lesion, mainly occurring in women using oral contraceptives. Patients are advised to stop using oral contraceptives (OC) and, as overweight is frequently observed, dietary restrictions. Metabolic changes are assumed to play a role and it has been suggested that diet may help to reduce tumour size. A low-calorie ketogenic diet (LCKD) has been shown to induce weight loss and multiple metabolic changes, including the reduction of portal insulin concentrations, which downregulates hepatic growth hormone receptors. Weight reduction and an LCKD can potentially reduce the size of HCAs.

Methods and analysis

We designed a matched, interventional cohort study to determine the effect of an LCKD on the regression of HCA. The study population consists of female subjects with an HCA, 18–50 years of age, body mass index>25 kg/m2, who are entering a surveillance period including cessation of OC. A historical control group will be matched. The intervention consists of an LCKD (approximately 35 g carbohydrate/1500 kcal/day) for 3 months, followed by a less strict LCKD for 3 months (approximately 60 g carbohydrate/1500 kcal/day). Main study endpoint is the diameter of the HCA after 6 months, as compared with the historic control group. Secondary endpoints include adherence, quality of life, change in physical activity, liver fat content, body weight, body composition and resting energy expenditure.

Ethics and dissemination

The medical ethical committee has approved the study protocol, patient information files and consent procedure and other study-related documents and procedures.

Trial registration number

NL75014.078.20; Pre-results. https://www.trialregister.nl/trial/9092
Prospective study of preoperative autologous blood donation for patients with high risk of allogeneic blood transfusion in lumbar fusion surgery: a study protocol of a randomised controlled trial
Authors: Xu Nanfang , Zhang Youyu , Tian Yun , Li Baohua , Qiao Haiqin , Zhang Xiaoqing , Yang Nan , Li Wei , Zhang Chao , Li Weishi , Fu Wei
Published: February 2022

Introduction

Preoperative autologous blood donation (PABD) can be used to reduce the exposure of allogeneic blood transfusion in patients undergoing elective surgery. Better blood management to avoid anaemia and reduce allogeneic blood transfusion after spine surgery become increasingly important with development of enhanced recovery after surgery. We present here the design of a randomised controlled trial with three groups to verify the clinical effectiveness of PABD in patients at high risk of transfusion for lumbar fusion surgery and explore the optimal timing of autologous blood donation.

Method and analysis

Patients (age 18–70 years) who will receive lumbar fusion surgery for degenerative disease with haemoglobin over 110 g/L and ‘high risk’ of allogeneic blood transfusion are eligible, unless they refuse participation or are diagnosed with malignant metastases, infection, cardiovascular and cerebrovascular diseases, haematological disorders or relevant drug history and critical illnesses. A total of 1200 patients will be recruited and randomised into three groups. Patients in group A will not receive PABD and be regarded as control group. PABD will be performed for patients in groups B and C. Blood donation will be finished at 1 week (±3 day) before surgery in group B and 2 weeks (±3 day) before surgery in group C. Primary outcome measures will include haemoglobin decline, incidence and amount of allogeneic blood transfusion. Secondary outcome measures will include days of hospitalisation after surgery, haematocrit level and incidence of complications. This study is a single-centre and open-label randomised controlled trial. The sample size is calculated with reference to the retrospective data and previous studies.

Ethics and dissemination

This trial has been approved by the Peking University Third Hospital Medical Science Research Ethic Committee (no: 2020-262-02). Results of the trial will be submitted for publication in a peer-reviewed journal and as conference presentations.

Trial registration number

ChiCTR2000039824, preresults.