bluuebunny/crossref_metadata_2025 huggingface dataset:
Aerodynamic Investigation of a Composite Low-Speed Fan for UHBR Application
Authors: Rodrigues Martin , Soulat Laurent , Paoletti Benoit , Ottavy Xavier , Brandstetter Christoph
Published: March 2021

A composite fan stage representative of a modern Ultra High Bypass Ratio (UHBR) architecture has been investigated experimentally on a novel test facility at Ecole Centrale de Lyon. These measurements show indications for strong overloading of the tip region resulting in extensive blockage of the blade passage. The performance of the fan is analyzed with extensive instrumentation including radial profiles upstream and downstream of the rotor. Unsteady pressure measurements help to interpret the flow structure in the tip region. The results are presented across a range of operating points on the design speedline. At the stability limit, the machine suffers from non-synchronous vibrations, which result from small-scale aerodynamic disturbances propagating between the leading edges. Detailed analysis of the occurring waveforms is presented for two operating speeds. In order to further analyze the observed phenomena, a numerical study has been conducted using the Reynolds-averaged Navier–Stokes (RANS) solver elsA. The results of steady calculations are discussed in comparison with the detailed experiments. Unsteady simulations near the stability limit accurately predict the aerodynamic disturbances observed during non-synchronous vibrations (NSV). The obtained results are unusual for typical state-of-the-art transonic fans, as they show the same behavior as high-pressure compressor front stages, dominated by a blockage caused by tip-leakage flow. Even though flutter is not observed, the observed non-synchronous vibration mechanism is a critical aeroelastic phenomenon which is of great interest for future designs of low-speed fans.
Effectiveness of Continuous Aerobic Versus High-Intensity Interval Training on Atherosclerotic and Inflammatory Markers in Boys With Overweight/Obesity
Authors: Paahoo Alireza , Tadibi Vahid , Behpoor Nasser
Published: March 2021

Purpose: Atherosclerosis is a complex multifactorial disease whose first steps can be initiated from childhood. Therefore, we examined the effects of 2 training models on salusins levels, inflammatory markers, and lipid profile in boys with overweight/obesity. Method: Forty-five boys with overweight/obesity with the mean age of 11.06 (1.0) years were randomly divided into three groups of 15: a high-intensity interval training (HIIT) group (100%–110% of maximum aerobic speed); an aerobic training group (40%–70% of heart rate reserve); and a control group. The intervention included 3 sessions per week for 12 weeks. Results: Findings showed significant improvements in serum levels of salusins, salusins ratio, interleukin-6 (IL-6), and total cholesterol (TC) in both training groups (P < .001). Also, the serum levels of C-reactive protein (CRP), triglycerides (TG), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), atherogenic index of plasma (AIP), and cholesterol index improved significantly (P < .01). Except for the TG, HIIT caused higher improvements than aerobic training (P < .001 for salusin-α, salusins ratio, IL-6, CRP, TC, HDL, AIP, and cholesterol index; and P < .01 for salusin-β and LDL). Conclusion: The present study shows that HIIT has more positive effects than aerobic exercise on the atherosclerotic and inflammatory factors, as well as lipid profile variables in children with overweight/obesity.
Catalytic photooxygenation degrades brain Aβ in vivo
Authors: Nagashima Nozomu , Ozawa Shuta , Furuta Masahiro , Oi Miku , Hori Yukiko , Tomita Taisuke , Sohma Youhei , Kanai Motomu
Published: March 2021

An intravenously injected chemical catalyst degraded and reduced amyloid-β protein in living mice brains under photoirradiation.
Evoking ordered vacancies in metallic nanostructures toward a vacated Barlow packing for high-performance hydrogen evolution
Authors: Zhang Zhicheng , Liu Guigao , Cui Xiaoya , Gong Yue , Yi Ding , Zhang Qinghua , Zhu Chongzhi , Saleem Faisal , Chen Bo , Lai Zhuangchai , Yun Qinbai , Cheng Hongfei , Huang Zhiqi , Peng Yongwu , Fan Zhanxi , Li Bing , Dai Wenrui , Chen Wei , Du Yonghua , Ma Lu , Sun Cheng-Jun , Hwang Inhui , Chen Shuangming , Song Li , Ding Feng , Gu Lin , Zhu Yihan , Zhang Hua
Published: March 2021

Rh nanostructures composed of nanosheets embedded with nanodomains adopt vacated Barlow packing with ordered vacancies.
Speleothem record of mild and wet mid-Pleistocene climate in northeast Greenland
Authors: Moseley G. E. , Edwards R. L. , Lord N. S. , Spötl C. , Cheng H.
Published: March 2021

First Greenland speleothem record indicates warmer and wetter climate between c.588 and c.549 ka ago.
Lymphangiogenesis-inducing vaccines elicit potent and long-lasting T cell immunity against melanomas
Authors: Sasso Maria Stella , Mitrousis Nikolaos , Wang Yue , Briquez Priscilla S. , Hauert Sylvie , Ishihara Jun , Hubbell Jeffrey A. , Swartz Melody A.
Published: March 2021

New approach for immune cell recruitment in therapeutic anticancer vaccines drives antigenically broad and long-lasting immunity.
Ca
2+
signals critical for egress and gametogenesis in malaria parasites depend on a multipass membrane protein that interacts with PKG
Authors: Balestra Aurélia C. , Koussis Konstantinos , Klages Natacha , Howell Steven A. , Flynn Helen R. , Bantscheff Marcus , Pasquarello Carla , Perrin Abigail J. , Brusini Lorenzo , Arboit Patrizia , Sanz Olalla , Castaño Laura Peces-Barba , Withers-Martinez Chrislaine , Hainard Alexandre , Ghidelli-Disse Sonja , Snijders Ambrosius P. , Baker David A. , Blackman Michael J. , Brochet Mathieu
Published: March 2021

A membrane protein interacts with PKG and regulates calcium signals at multiple lifecycle stages in malaria parasites.
Direct 2D-to-3D transformation of pen drawings
Authors: Song Seo Woo , Lee Sumin , Choe Jun Kyu , Kim Na-Hyang , Kang Junwon , Lee Amos Chungwon , Choi Yeongjae , Choi Ahyoun , Jeong Yunjin , Lee Wooseok , Kim Ju-Young , Kwon Sunghoon , Kim Jiyun
Published: March 2021

Technology for transforming a 2D pen drawing into a designed 3D structure enables highly accessible, rapid 3D fabrication.
Deviating from the pure MAX phase concept: Radiation-tolerant nanostructured dual-phase Cr
2
AlC
Authors: Tunes M. A. , Imtyazuddin M. , Kainz C. , Pogatscher S. , Vishnyakov V.M.
Published: March 2021

Nanocrystallinity prevents irradiation-induced amorphization of nonpure Cr
2
AlC MAX phase thin film.
Amphiphilic Ti porous transport layer for highly effective PEM unitized regenerative fuel cells
Authors: Lim Ahyoun , Jeong Hui-Yun , Lim Youngjoon , Kim Jin Young , Park Hee Young , Jang Jong Hyun , Sung Yung-Eun , Kim Jong Min , Park Hyun S.
Published: March 2021

Amphiphilic transport layer enables facile mass transportation of both gas and water for highly efficient PEM unitized fuel cells.
Architecture and mechanism of metazoan retromer:SNX3 tubular coat assembly
Authors: Leneva Natalya , Kovtun Oleksiy , Morado Dustin R. , Briggs John A. G. , Owen David J.
Published: March 2021

Cryo–electron tomography shows how retromer recruits cargo and tubulates endosomes without canonical membrane-bending proteins.
An intracortical neuroprosthesis immediately alleviates walking deficits and improves recovery of leg control after spinal cord injury
Authors: Bonizzato Marco , Martinez Marina
Published: March 2021

Phase-coherent intracortical stimulation immediately alleviates foot-drop and fosters recovery of leg control in incomplete spinal cord injury rats.
Chimeric STAR receptors using TCR machinery mediate robust responses against solid tumors
Authors: Liu Yue , Liu Guangna , Wang Jiasheng , Zheng Zhe-yu , Jia Lemei , Rui Wei , Huang Daosheng , Zhou Zhi-xiao , Zhou Liqun , Wu Xin , Lin Song , Zhao Xueqiang , Lin Xin
Published: March 2021

T cells engineered with synthetic receptors that integrate components of T cell and B cell receptors show efficacy against solid tumors in mice.
Amplicon of 16S rRNA Gene Sequencing of Fertilized Volcanic Soils from Southern Chile
Authors: Vargas Rodrigo A. , Valdés Natalia , Balic Iván , Contreras Eduardo I. , Venegas Carlos , Aranada Carlos P. , Tello Mario , Gonzalez Alex R.
Published: March 2021

The volcanic soils of Chiloé Island, have physical and chemical characteristics that affect their productivity. We report here a 16S rRNA gene analysis that characterizes the predominant microbial communities in volcanic soils of Chiloé either in the presence or absence of fertilization. The major phyla identified were
Proteobacteria
,
Acidobacteria
, and
Actinobacteria
.
Draft Genome Sequence of a Polymyxin-Resistant Klebsiella pneumoniae Clinical Strain Carrying
mcr-8.1
and
bla
NDM-5
Authors: Pei Na , Jian Zijuan , Liu Yirui , Liang Tianzhu , Liu Wenen , Li Junhua
Published: March 2021

Carbapenem-resistant
Klebsiella pneumoniae
(CRKP) is a major threat to global health. Here, we report the draft genome sequence of a
Klebsiella pneumoniae
clinical strain carrying
mcr-8.1
and
bla
NDM-5
.
Genome Sequence of the Black Yeast-Like Strain Aureobasidium pullulans var.
aubasidani
CBS 100524
Authors: Vignolle Gabriel A. , Mach Robert L. , Mach-Aigner Astrid R. , Derntl Christian
Published: March 2021

In this work, we present the whole-genome sequence and the complete mitochondrial sequence of the black yeast-like strain
Aureobasidium pullulans
var.
aubasidani
CBS 100524, which produces the exopolysaccharide aubasidan and was previously isolated from
Betula
sp. slime flux from the Leningrad region, Russia.
Mo isotope records from Lower Cambrian black shales, northwestern Tarim Basin (China): Implications for the early Cambrian ocean
Authors: Zhu Guangyou , Li Tingting , Zhao Kun , Li Chao , Cheng Meng , Chen Weiyan , Yan Huihui , Zhang Zhiyao , Algeo Thomas J.
Published: March 2021

The widely developed black shales deposited during the early Cambrian recorded paleoenvironmental information about coeval seawater. Numerous studies have been conducted on these shales to reconstruct the paleomarine environment during this time period. However, most research has been conducted on stratigraphic sections in South China, and equivalent studies of sections from other cratons are relatively rare. Here, we report Mo isotopic compositions as well as redox-sensitive trace-element and iron (Fe) speciation data for black shales of the Lower Cambrian Yuertusi Formation from the Tarim block (i.e., a small craton). The Fe speciation data show high FeHR/FeT and Fepy/FeHR ratios, indicating roughly sustained euxinic bottom-water conditions during their deposition. Based on Mo isotopic compositions (δ98/95Mo), we further classified the euxinic black shales into two intervals: a lower interval (0–21.3 m) and an upper interval (21.3–32.3 m). The lower interval is characterized by variable Mo isotopic compositions (−2.12‰ to +0.57‰, mean = –0.52‰ ± 0.72‰), with an obvious negative excursion in its middle portion. The overlying upper interval has relatively heavy δ98/95Mo values up to +1.42‰ (mean = +0.62‰ ± 0.37‰). We ascribe δ98/95Mo differences in the lower and upper intervals to inadequate aqueous H2S concentrations for quantitative thiomolybdate formation under euxinic conditions. The most negative Mo isotope excursion may have been caused by upwelling hydrothermal inputs during a transgression, consistent with significantly elevated total organic carbon (TOC) contents, Mo and U enrichments, and Fe supply. Relatively positive δ98/95Mo values in the upper interval have roughly similar variations with other coeval sections, indicating such variations were common for early Cambrian euxinic deposits, and they were most likely caused by local differences in [H2S]aq. Compilation of Mo isotope data from the early Cambrian and earlier times further indicates relatively oxygenated seawater, especially the deep-marine areas during the early Cambrian before reaching a state like modern seawater.
Supplemental Material: The carbonate compensation depth in the South Atlantic Ocean since the Late Cretaceous
Authors: Dutkiewicz Adriana , Müller Dietmar
Published: March 2021

Description of datasets and data sources, Figures S1–S14, and Table S1.
Bone mineral density changes in a free vascularised fibular graft in the distal femoral bone after osteosarcoma in a 10-year-old boy: a 7-year follow-up
Authors: Jørgensen Andrea René , Jørgensen Peter Holmberg , Jul Kiil Birgitte , Stilling Maiken
Published: March 2021

A 10-year-old boy presented with continuous reports of pain located to the left knee. Imaging revealed a sclerotic process in the left distal femur, and biopsies were consistent with chondroblastic osteosarcoma. As part of standard treatment the patient underwent neoadjuvant chemotherapy followed by limb sparring surgery and adjuvant chemotherapy. The entire tumour was excised and femoral bone reconstruction was performed with a double barrel free vascularised fibular graft. Bone mineral density (BMD) can be decreased in childhood survivors of cancer. The patient was followed for 7 years with dual-energy X-ray absorptiometry scans in order to assess BMD and graft adaption. Despite two accidental fractures to the graft region local and global BMD underwent an overall increase. Approximately 7 years after tumour resection the patient had a global Z-score of 0.2, which is considered within normal range.
Dynamic left ventricular outflow tract obstruction in Takotsubo cardiomyopathy resulting in cardiogenic shock
Authors: Conradi Paulina M , van Loon Ramon B , Handoko M Louis
Published: March 2021

We report a case of a 73-year-old female patient, who was admitted to the coronary care unit due to chest pain, malaise and near syncope. During physical examination, the patient was hypotensive and there were signs of left-sided heart failure and a loud systolic murmur. Echocardiogram showed apical ballooning with dynamic left ventricular outflow tract obstruction, based on systolic anterior motion of the mitral valve with important mitral valve regurgitation. In the acute setting, the cardiogenic shock was treated cautiously with fluid resuscitation and intravenous metoprolol, resulting in direct stabilisation of her haemodynamic condition. As a codiagnosis, there was a significant stenosis of left anterior descending artery, which was treated successfully by percutaneous coronary intervention with drug eluting stents. During follow-up, left ventricular function normalised, and the left ventricular outflow tract obstruction, systolic anterior motion of mitral valve and related mitral regurgitation all resolved.
Capecitabine-induced hyperosmolar hyperglycaemic state
Authors: Yim Carly , Hussein Nassrein , Arnason Terra
Published: March 2021

An elderly woman with metastatic breast cancer was admitted with hyperglycaemic hyperosmolar state (HHS) and an elevated haemoglobin A1C. For 1 week, she had experienced confusion, nausea and frequent urination. Preceding this, she had completed seven cycles of capecitabine chemotherapy for her breast cancer. She did not have a history of diabetes prior to chemotherapy. Given the temporal dysglycaemia following the patient’s chemotherapy regimen, capecitabine was thought to be a probable offending agent. The patient was acutely treated for HHS, and was discharged on a basal-bolus insulin regimen. Her capecitabine was held pending review with her oncology team. The patient was ultimately titrated down to basal insulin only by her family doctor. Given the common use of capecitabine, it is important to recognise the risk of hyperglycaemic and hyperglycaemic emergencies as potential adverse effects. This highlights the need to monitor blood glucose throughout treatment to prevent hyperglycaemic emergencies.
Glycemic variability and cardiovascular disease in patients with type 2 diabetes
Authors: Martinez Marcela , Santamarina Jimena , Pavesi Adrian , Musso Carla , Umpierrez Guillermo E
Published: March 2021

Glycated hemoglobin is currently the gold standard for assessment of long-term glycemic control and response to medical treatment in patients with diabetes. Glycated hemoglobin, however, does not address fluctuations in blood glucose. Glycemic variability (GV) refers to fluctuations in blood glucose levels. Recent clinical data indicate that GV is associated with increased risk of hypoglycemia, microvascular and macrovascular complications, and mortality in patients with diabetes, independently of glycated hemoglobin level. The use of continuous glucose monitoring devices has markedly improved the assessment of GV in clinical practice and facilitated the assessment of GV as well as hypoglycemia and hyperglycemia events in patients with diabetes. We review current concepts on the definition and assessment of GV and its association with cardiovascular complications in patients with type 2 diabetes.
Association of exercise participation levels with cardiometabolic health and quality of life in individuals with hepatitis C
Authors: Hallsworth Kate , Gosrani Shion , Hogg Sarah , Patel Preya , Wetten Aaron , Welton Rachael , McPherson Stuart , Campbell Matthew D
Published: March 2021

Objective

Hepatitis C virus (HCV) infection is associated with an increased risk of cardiovascular disease (CVD) and reduced health-related quality of life (HRQoL). Although physical activity (PA)/exercise has been shown to reduce CVD risk and improve HRQoL in patients with liver disease, there is limited data in HCV. We aimed to explore the association between PA/exercise levels, CVD risk and HRQoL in patients with HCV and assess individuals’ attitudes to PA/exercise.

Design

Cross-sectional observational study recruiting consecutive patients with HCV from viral hepatitis clinics. Data were collected on CVD risk factors, anthropometry, HRQoL and the Exercise Benefits and Barriers Scale (EBBS).

Results

86 patients were recruited (71% men, 94% white, age 52±13 years); 49% of the cohort self-reported to be currently active. Although HRQoL was reduced across the cohort, patients that were regularly ‘active’ reported significantly higher HRQoL scores across Short-Form 36v2 domains compared with their inactive counterparts (p<0.05). Metabolic and cardiovascular characteristics were no different between groups stratified by PA/exercise status (p>0.05). EBBS scores were similar in the ‘active’ versus ‘inactive’ groups, however, patients categorised as ‘active’ scored significantly higher on the psychological outlook and social interaction subscales (p<0.05) than those that were ‘inactive’. There were significant associations between EBBS scores and HRQoL (p<0.05).

Conclusions

PA/exercise is associated with increased HRQoL in patients with HCV irrespective of clinical parameters. Addressing specific motivators/barriers to exercise for patients will be key to designing effective PA/exercise interventions in this patient population to ensure maximum uptake and adherence.
Protocol for a systematic review of barriers, facilitators and outcomes in primary healthcare services for women in Pakistan
Authors: Jafree Sara Rizvi , Mahmood Qaisar Khalid , Momina Ain ul , Fischer Florian , Barlow Jane
Published: March 2021

Introduction

The lack of universal health coverage and high poverty rates among the majority of women in Pakistan makes it essential to understand the quality and effectiveness of primary healthcare services. The aim of this project is to systematically review the available literature for interventions for primary healthcare services for women in order to provide the basis for future healthcare policy. The primary objective is to identify the effectiveness of the intervention in terms of how successful it was in improving health of women; whereas the secondary aim is to identify barriers and facilitators for delivery of primary healthcare services.

Methods and analysis

A systematic review using a narrative synthesis will be undertaken, including qualitative, quantitative and mixed methods studies from January to June 2021. Electronic databases will be used including PubMed, BMC, Medline, CINAHL and Cochrane Library. The search will be conducted in English and no date restrictions will be applied. A thematic synthesis method will be used for data synthesis involving three steps: (1) the identification, coding and initial theme generation for effectiveness of primary healthcare interventions in Pakistan for women, (2) identification and grouping of overarching themes, and related subthemes, to develop descriptive themes for barriers and facilitators for primary healthcare delivery, and (3) generation of general analytical themes in order to present recommendations in terms of improved health outcomes for women.

Ethics and dissemination

Ethics approval for this study was obtained from the Institutional Review Board, Forman Christian College University. Results will be disseminated via publications in international peer-reviewed journals. In addition, conference proceedings will be used to inform the government, researchers, donors, non-governmental organisations and other stakeholders. This study will result in a systematic identification and synthesis of barriers and facilitators for women’s health outcomes that will help inform future primary health policies.

PROSPERO registration number

CRD42020203472.
Anticholinergic drug burden according to the anticholinergic drug scale and the German anticholinergic burden and their impact on cognitive function in multimorbid elderly German people: a multicentre observational study
Authors: Krüger Caroline , Schäfer Ingmar , van den Bussche Hendrik , Bickel Horst , Fuchs Angela , Gensichen Jochen , König Hans-Helmut , Maier Wolfgang , Mergenthal Karola , Riedel-Heller Steffi G , Schön Gerhard , Weyerer Siegfried , Wiese Birgitt , von Renteln-Kruse Wolfgang , Langebrake Claudia , Scherer Martin
Published: March 2021

Objectives

The aims of our study were to examine the anticholinergic drug use and to assess the association between anticholinergic burden and cognitive function in the multimorbid elderly patients of the MultiCare cohort.

Setting

MultiCare was conducted as a longitudinal cohort study in primary care, located in eight different study centres in Germany.

Participants

3189 patients (59.3% female).

Primary and secondary outcome measures

Baseline data were used for the following analyses. Drugs were classified according to the well-established anticholinergic drug scale (ADS) and the recently published German anticholinergic burden (German ACB). Cognitive function was measured using a letter digit substitution test (LDST) and a mixed-effect multivariate linear regression was performed to calculate the influence of anticholinergic burden on the cognitive function.

Results

Patients used 1764 anticholinergic drugs according to ADS and 2750 anticholinergics according to the German ACB score (prevalence 38.4% and 53.7%, respectively). The mean ADS score was 0.8 (±1.3), and the mean German ACB score was 1.2 (±1.6) per patient. The most common ADS anticholinergic was furosemide (5.8%) and the most common ACB anticholinergic was metformin (13.7%). The majority of the identified anticholinergics were drugs with low anticholinergic potential: 80.2% (ADS) and 73.4% (ACB), respectively. An increasing ADS and German ACB score was associated with reduced cognitive function according to the LDST (−0.26; p=0.008 and −0.24; p=0.003, respectively).

Conclusion

Multimorbid elderly patients are in a high risk for using anticholinergic drugs according to ADS and German ACB score. We especially need to gain greater awareness for the contribution of drugs with low anticholinergic potential from the cardiovascular system. As anticholinergic drug use is associated with reduced cognitive function in multimorbid elderly patients, the importance of rational prescribing and also deprescribing needs to be further evaluated.

Trial registration number

ISRCTN89818205.
Design of a randomised controlled trial: does indirect calorimetry energy information influence weight loss in obesity?
Authors: Lim Jonathan , Alam Uazman , Cuthbertson Daniel , Wilding John
Published: March 2021

Introduction

Respiratory quotient (RQ) provides an indication of the relative balance of carbohydrate and fat oxidation. RQ could serve as an early biomarker of negative energy balance during weight loss. Restriction of energy intake relative to total daily energy requirements produces a negative energy balance which can lead to a fall in RQ, accompanied by a decrease in resting energy expenditure (REE). However, the net change in body weight does not usually match predicted weight change due to intraindividual metabolic adaptations. Our aim is to determine the effectiveness of utilising EE information from indirect calorimetry during weight loss intervention.

Methods and analysis

We will undertake an assessor-blinded, parallel-group randomised controlled trial of 105 adults with obesity randomised in 1:1 ratio to receive either standard weight management care (SC) or EE information plus SC (INT) during a 24-week multicomponent weight management programme. The primary outcome is difference in weight loss between INT and SC group at 24 weeks. Secondary outcomes include: change in RQ, REE, glycaemic variability, and appetite-relating gut hormones (glucagon-like peptide 1, gastric inhibitory polypeptide, peptide YY). Generalised linear mixed models (intention to treat) will assess outcomes for treatment (INT vs SC), time (baseline, 24 weeks) and the treatment-by-time interaction. This will be the first study to evaluate impact of utilising measured REE and RQ on the lifestyle-based intensive intervention programme.

Ethics and dissemination

Ethics approval was obtained from the Health Research Authority and the North West Research Ethics Committee (18/NW/0645). Results from this trial will be disseminated through publication in peer-reviewed journals, national and international presentations.

Trial registration numbers

NCT03638895; UoL001379.
Cohort profile: the Chinese Pregnant Women Cohort Study and Offspring Follow-up (CPWCSaOF)
Authors: Lyu Tianchen , Chen Yunli , Zhan Yongle , Shi Yingjie , Yue Hexin , Liu Xuan , Meng Yaohan , Jing Ao , Qu Yimin , Ma Haihui , Huang Ping , Man Dongmei , Li Xiaoxiu , Wu Hongguo , Zhao Jian , Shan Guangliang , Jiang Yu
Published: March 2021

Purpose

A multicentre prospective cohort study, known as the Chinese Pregnant Women Cohort Study (CPWCS), was established in 2017 to collect exposure data during pregnancy (except environmental exposure) and analyse the relationship between lifestyle during pregnancy and obstetric outcomes. Data about mothers and their children’s life and health as well as children’s laboratory testing will be collected during the offspring follow-up of CPWCS, which will enable us to further investigate the longitudinal relationship between exposure in different periods (during pregnancy and childhood) and children’s development.

Participants

9193 pregnant women in 24 hospitals in China who were in their first trimester (5–13 weeks gestational age) from 25 July 2017 to 26 November 2018 were included in CPWCS by convenience sampling. Five hospitals in China which participated in CPWCS with good cooperation will be selected as the sample source for the Chinese Pregnant Women Cohort Study (Offspring Follow-up) (CPWCS-OF).

Findings to date

Some factors affecting pregnancy outcomes and health problems during pregnancy have been discovered through data analysis. The details are discussed in the ‘Findings to date’ section.

Future plans

Infants and children and their mothers who meet the criteria will be enrolled in the study and will be followed up every 2 years. The longitudinal relationship between exposure (questionnaire data, physical examination and biospecimens, medical records, and objective environmental data collected through geographical information system and remote sensing technology) in different periods (during pregnancy and childhood) and children’s health (such as sleeping problem, oral health, bowel health and allergy-related health problems) will be analysed.

Trail registration number

CPWCS was registered with ClinicalTrials.gov on 18 January 2018:NCT03403543. CPWCS-OF was registered with ClinicalTrials.gov on 24 June 2020:NCT04444791.
Exploration of recovery of people living with severe mental illness (SMI) in low/middle-income countries (LMICs): a scoping review
Authors: Gamieldien Fadia , Galvaan Roshan , Myers Bronwyn , Syed Zarina , Sorsdahl Katherine
Published: March 2021

Objective

To examine the literature on how recovery of people with severe mental illness (SMI) is conceptualised in low/middle-income countries (LMICs), and in particular what factors are thought to facilitate recovery.

Design

Scoping review.

Data sources and eligibility

We searched 14 electronic databases, hand searched citations and consulted with experts during the period May–December 2019. Eligible studies were independently screened for inclusion and exclusion by two reviewers. Unresolved discrepancies were referred to a third reviewer.

Data extraction and synthesis

All bibliographical data and study characteristics were extracted using a data charting form. Selected studies were analysed through a thematic analysis emerging from extracted data.

Results

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram offers a summary of the results: 4201 titles, 1530 abstracts and 109 full-text articles were screened. Ten articles were selected for inclusion: two from Turkey, two from India, and one each from China, Swaziland, Indonesia, Egypt, South Africa and Vietnam. Although most studies used qualitative methods, data collection and sampling methods were heterogeneous. One study reported on service provider perspectives while the rest provided perspectives from a combination of service users and caregivers. Three themes emerged from the data analysis. First, studies frame recovery as a personal journey occurring along a continuum. Second, there was an emphasis on social relationships as a facilitator of recovery. Third, spirituality emerged as both a facilitator and an indicator of recovery. These themes were not mutually exclusive and some overlap exists.

Conclusion

Although there were commonalities with how high-income countries describe recovery, we also found differences in conceptualisation. These differences in how recovery was understood reflect the importance of framing the personal recovery concept in relation to local needs and contextual issues found in LMICs. This review highlighted the current sparse evidence base and the need to better understand recovery from SMI in LMICs.
Detection of IgM, IgG and SARS-CoV-2 RNA among the personnel of the University of Milan, March through May 2020: the UNICORN study
Authors: Milani Gregorio Paolo , Rota Federica , Favero Chiara , Dioni Laura , Manenti Alessandro , Hoxha Mirjam , Pariani Elena , Albetti Benedetta , Pesatori Angela Cecilia , Montomoli Emanuele , Bollati Valentina
Published: March 2021

Objectives

In Italy, the pandemic of COVID-19 resulted in congestion of hospitals and laboratories and probably determined an underestimation of the number of infected subjects, as the molecular diagnosis of SARS-CoV-2 infection was mainly performed on hospitalised patients. Therefore, limited data are available about the number of asymptomatic/paucisymptomatic subjects in the general population across time. To understand SARS-CoV-2 infection in the general population, we have developed a cross-sectional study (the ‘UNIversity against CORoNavirus study’) to investigate infection trends in asymptomatic/paucisymptomatic subjects in Milan (Italy), between March and June 2020.

Participants

The study population included 2023 subjects asymptomatic at the enrolment.

Primary outcome measures

A nasal mid-turbinate swab for the detection of SARS-CoV-2 RNA and blood specimen for testing serum antibodies (immunoglobulin M (IgM) and IgG) were collected.

Results

Subjects showing positivity for the SARS-CoV-2 RNA and/or for anti-SARS-CoV-2 Ig is 237 (11.7%). Only 1.2% (n=25) of the total population had a positive nasal swab for SARS-CoV-2 and the large majority (21/25) of them were observed in March. A total of 226 subjects (11%) had IgM (n=19; 0.9%), IgG (n=155; 7.7%) or both (n=52; 2.6%) against SARS-CoV-2. Subjects with a present or past SARS-CoV-2 infection did not differ from other subjects as regards the number of cohabiting family members, travels, fever and upper and lower respiratory infection episodes.

Conclusions

Results from the present study support the hypothesis that the actual spread of the virus in Lombardy was underestimated in the official records. However, as it is not known how long Ig persist, numbers should be taken cautiously.
Anti-inflammatory treatment after cataract surgery in Sweden: changes in prescribing patterns from 2010 to 2017
Authors: Samadi Behrad , Lundstrom Mats , Zetterberg Madeleine , Nilsson Ingela , Montan Per , Behndig Anders , Kugelberg Maria
Published: March 2021

Aims

To investigate changes in the prescribing patterns of postoperative eye drops following cataract surgery in Sweden from 2010 to 2017.

Methods

Data from cataract procedures registered in the National Cataract Register during the month of March from 2010 to 2017 were record linked and sent to the Swedish Prescribed Drug Register, which allowed us to determine which eye drops the patients had obtained from 3 months presurgery to 2 weeks post surgery.

Results

During the 8-year study period, 54 889 surgeries were registered. Combination treatment with steroid and non-steroidal anti-inflammatory drug (NSAID) eye drops increased from 12% in 2010 to 60% in 2017 (p<0.001) while monotherapy with steroids decreased from 71% in 2010 to 26% in 2017 (p<0.001). Monotherapy with NSAIDs after surgery was fairly stable, at 17% in 2010 and 13% in 2017 (p<0.001). Combination treatment was more frequent in patients with diabetic retinopathy (p<0.001) or age-related macular degeneration (p<0.001), while monotherapy with steroids was more frequent in patients with glaucoma (p<0.001). The proportion of monotherapy or combination therapy varied widely between ophthalmic clinics. The prescription of antibiotic eye drops after surgery also varied greatly between clinics, from 0% to 63%, with a national average of 4.9%.

Conclusion

There is a change in the prescription pattern of anti-inflammatory eye drops after cataract surgery in Sweden, with less monotherapy and an increasing proportion of patients receiving a combination of steroid and NSAID eye drops.
SARS-CoV-2 transmissions in students and teachers: seroprevalence follow-up study in a German secondary school in November and December 2020
Authors: Armann Jakob Peter , Kirsten Carolin , Galow Lukas , Kahre Elisabeth , Haag Luise , Dalpke Alexander , Lück Christian , Berner Reinhard
Published: March 2021

Objective

To quantify the number of undetected SARS-CoV-2 infections in educational settings.

Design

Serial SARS-CoV-2 seroprevalence study before and during the second wave of the COVID-19 pandemic.

Setting

Secondary school in Dresden, Germany.

Participants

Grade 8–12 students and their teachers were invited to participate in serial blood sampling and SARS-CoV-2 IgG antibody assessment.

Main outcome measure

Seroprevalence of SARS-CoV-2 antibodies in study population.

Results

247 students and 55 teachers participated in the initial study visit and 197 students and 40 teachers completed follow-up. Seroprevalence increased from 1.7% (0.3–3.3) to 6.8% (3.8–10.1) during the study period mirroring the increase of officially reported SARS-CoV-2 infections during this time. The ratio of undetected to detected SARS-CoV-2 infections ranged from 0.25 to 0.33.

Conclusions

We could not find evidence of relevant silent, asymptomatic spread of SARS-CoV-2 in schools neither in a low prevalence setting nor during the second wave of the pandemic, making it unlikely that educational settings play a crucial role in driving the SARS-CoV-2 pandemic.

Trial registration number

DRKS00022455.
Rawlsian justice in healthcare: a response to Cox and Fritz
Authors: Sarela Abeezar I
Published: March 2021

Cox and Fritz state the central problem as the absence of a framework for healthcare policy decisions; but, they overlook the theoretical underpinnings of public law. In response, they propose a two-step procedure to guide fair decision-making. The first step relies on Thomas Scanlon’s ‘contractualism’ for stakeholders to consider whether, or not, they could reasonably reject policy proposals made by others; then in the second step, John Rawls’s principles of justice are applied to these proposals; a fair policy requires to pass both steps. I argue that Cox and Fritz misinterpret Rawls. His theory has two stages: first, public reason is used to generate principles of justice; second, public reason is used to interpret and apply these principles. The second stage requires that proposals are based on the principles of justice from the first stage, and these proposals have to be acceptable to reasonable persons. Thus, Rawls’s theory does not need Scanlonian supplementation. Moreover, the application of Rawls’s theory in Cox and Fritz’s model is confusing. In any case, the problems with applying Rawlsian justice to healthcare can be located elsewhere. First, Rawls’s theory would treat healthcare simply as a ‘primary good’ or resource. Social justice ought to, instead, consider healthcare as an opportunity, in the manner conceived by Amartya Sen. Second, Rawlsian justice rests, ultimately, on the conception of a reasonable person; until and unless the characteristics of reasonable stakeholders are clarified, any model of health justice will remain hostage to the unreasonable.
Treating traumatic thoracolumbar spine fractures using minimally invasive percutaneous stabilization plus balloon kyphoplasty: a 102-patient series
Authors: Salle Henri , Meynard Alexandre , Auditeau Emilie , Gantois Clément , Rouchaud Aymeric , Mounayer Charbel , Faure Patrick , Caire François
Published: March 2021

Background

There is no consensus on the treatment for spinal injuries resulting in thoracolumbar fractures without neurological impairment. Many trauma centers are opting for open surgery rather than a neurointerventional approach combining posterior percutaneous short fixation (PPSF) plus balloon kyphoplasty (BK).

Objective

To assess the safety and efficacy of PPSF+BK and to estimate the expected improvement by clarifying the factors that influence improvement.

Methods

We retrospectively reviewed patients who underwent PPSF+BK for the treatment of single traumatic thoracolumbar fractures from 2007 to 2019. Kyphosis, loss of vertebral body height (VBH), clinical and functional outcomes including visual analog scale and Oswestry disability index were assessed. We examined the overall effects in all patients by constructing a linear statistical model, and then examined whether efficacy was dependent on the characteristics of the patients or the fractures.

Results

A total of 102 patients were included. No patient experienced neurological worsening or wound infections. The average rates of change were 74.4% (95% CI 72.6% to 76.1%) for kyphosis and 85.5% (95% CI 84.4% to 86.6%) for VBH (both p<0.0001). The kyphosis treatment was more effective on Magerl A3 and B2 fractures than on those classified as A2.3, as well as for fractures with slight posterior wall protrusion on the spinal canal. A higher postoperative visual analog scale score was predictive of poorer outcome at 1 year.

Conclusions

This is the largest series reported to date and confirms and validates this surgical treatment. All patients exhibited improved kyphosis and restoration of VBH. We advise opting for this technique rather than open surgery.
Implementing the SNIS recommendations for neurointerventional emergent care in the setting of COVID-19: impact on stroke metrics and patient outcomes
Authors: Atchie Benjamin , Jarvis Stephanie , Stoddard Erica , Salottolo Kristin , Nieberlein Amy , McCarthy Kathryn , Bartt Russell , Bennett Alicia , Burrell Christian , Frei Donald , Bar-Or David
Published: March 2021

Background

It is not clear whether the COVID-19 pandemic and subsequent Society of Neurointerventional Surgery (SNIS) recommendations affected hospital stroke metrics.

Methods

This retrospective cohort study compared stroke patients admitted to a comprehensive stroke center during the COVID-19 pandemic April 1 2020 to June 30 2020 (COVID-19) to patients admitted April 1 2019 to June 30 2019. We examined stroke admission volume and acute stroke treatment use.

Results

There were 637 stroke admissions, 52% in 2019 and 48% during COVID-19, with similar median admissions per day (4 vs 3, P=0.21). The proportion of admissions by stroke type was comparable (ischemic, P=0.69; hemorrhagic, P=0.39; transient ischemic stroke, P=0.10). Acute stroke treatment was similar in 2019 to COVID-19: tPA prior to arrival (18% vs, 18%, P=0.89), tPA treatment on arrival (6% vs 7%, P=0.85), and endovascular therapy (endovascular therapy (ET), 22% vs 25%, P=0.54). The door to needle time was also similar, P=0.12, however, the median time from arrival to groin puncture was significantly longer during COVID-19 (38 vs 43 min, P=0.002). A significantly higher proportion of patients receiving ET were intubated during COVID-19 due to SNIS guideline implementation (45% vs 96%, P<0.0001). There were no differences by study period in discharge mRS, P=0.84 or TICI score, P=0.26.

Conclusions

The COVID-19 pandemic did not significantly affect stroke admission volume or acute stroke treatment utilization. Outcomes were not affected by implementing SNIS guidelines. Although there was a statistical increase in time to groin puncture for ET, it was not clinically meaningful. These results suggest hospitals managing patients efficiently can implement practices in response to COVID-19 without impacting outcomes.
sTWEAK is a marker of early haematoma growth and leukoaraiosis in intracerebral haemorrhage
Authors: da Silva-Candal Andrés , López-Dequidt Iria , Rodriguez-Yañez Manuel , Ávila-Gómez Paulo , Pumar José Manuel , Castillo José , Sobrino Tomás , Campos Francisco , Iglesias-Rey Ramón , Hervella Pablo
Published: March 2021

Objective

To study the association between early growth of haematoma with biomarkers of endothelial dysfunction such as leukoaraiosis (LA) and the soluble tumour necrosis factor-like weak inducer of apoptosis (sTWEAK) in patients with intracerebral haemorrhage (ICH).

Methods

This is a retrospective observational study of patients with nontraumatic ICH. Clinical and biochemical parameters were analysed. sTWEAK levels were measured by ELISA. LA was analysed in the hemisphere without haemorrhage to avoid interference with the acute injury. The main endpoint was the haematoma growth evaluated by the difference in volume between the second and the initial neuroimage. Poor functional outcome, defined as a modified Rankin Scale >2 at 3 months, was considered as secondary endpoint. Receiver operating characteristic curve analysis was performed to stablish the best cut-off for sTWEAK levels associated with haematoma growth.

Results

We included 653 patients with ICH in our analysis (71.1±11.9 years, 44% women). Haematoma growth was observed in 188 patients (28.8%). sTWEAK levels ≥5600 pg/mL predicted ICH growth with a sensitivity of 84% and a specificity of 87%. sTWEAK levels ≥5600 pg/mL and the presence of LA were associated with haematoma growth (OR: 42.46; (CI 95% 22.67 to 79.52) and OR: 2.73 (CI 95% 1.39 to 5.34), respectively). Also, the presence of LA (OR: 4.31 (CI 95% 2.89 to 6.42)) and the interaction between ICH growth and sTWEAK (OR: 2.23 (CI 95% 1.40 to 3.55)) were associated with poor functional outcome at 3 months.

Conclusion

sTWEAKs, together with the presence and grade of LA, are biomarkers able to predict ICH growth and poor functional outcome in patients with ICH.
Supersymmetric spin–phonon coupling prevents odd integer spins from quantum tunneling
Authors: Irländer Kilian , Schmidt Heinz-Jürgen , Schnack Jürgen
Published: March 2021

Quantum tunneling of the magnetization is a phenomenon that impedes the use of small anisotropic spin systems for storage purposes even at the lowest temperatures. Phonons, usually considered for temperature dependent relaxation of magnetization over the anisotropy barrier, also contribute to magnetization tunneling for integer spin quantum numbers. Here we demonstrate that certain spin–phonon Hamiltonians are unexpectedly robust against the opening of a tunneling gap, even for strong spin–phonon coupling. The key to understanding this phenomenon is provided by an underlying supersymmetry that involves both spin and phonon degrees of freedom.
Synthesis, photophysical properties and photodynamic antimicrobial activity of meso 5,10,15,20-tetra(pyren-1-yl)porphyrin and its indium(III) complex
Authors: Khisa Jackline , Derese Solomon , Mack John , Amuhaya Edith , Nyokong Tebello
Published: March 2021

In this study, free-base meso 5,10,15,20-tetra(pyren-1-yl)porphyrin (H2TPyP) and its corresponding indium(III) complex (InClTPyP) were synthesized and characterized on the basis of mass spectrometry, 1H NMR spectroscopy and elemental analysis. InClTPyP was obtained in good yield by treating the free base H2TPyP with indium(III) chloride. Purification of these compounds was achieved through column chromatography using different solvent systems. Metallation of the free base to form a metallo-porphyrin afforded improved photophysical properties. There was a bathochromic shift in wavelength of absorption from the parent free base H2TPyP ([Formula: see text] = 431 nm) to metallated indium(III) complex ([Formula: see text] = 443 nm). The fluorescence quantum yield in H2TPyP was higher ([Formula: see text] = 0.131) than in InClTPyP ([Formula: see text] = 0.017) due to efficient intersystem crossing to the triplet manifold in the metallated porphyrin. Upon illumination, both H2TPyP and InClTPyP show effective dose dependent antimicrobial activity against Staphylococcus aureus with photoinactivation IC[Formula: see text] values of 27.89 and 16.67 [Formula: see text]M, respectively.
Inferring Macroscale Brain Dynamics via Fusion of Simultaneous EEG-fMRI
Authors: Philiastides Marios G. , Tu Tao , Sajda Paul
Published: March 2021

Advances in the instrumentation and signal processing for simultaneously acquired electroencephalography and functional magnetic resonance imaging (EEG-fMRI) have enabled new ways to observe the spatiotemporal neural dynamics of the human brain. Central to the utility of EEG-fMRI neuroimaging systems are the methods for fusing the two data streams, with machine learning playing a key role. These methods can be dichotomized into those that are symmetric and asymmetric in terms of how the two modalities inform the fusion. Studies using these methods have shown that fusion yields new insights into brain function that are not possible when each modality is acquired separately. As technology improves and methods for fusion become more sophisticated, the future of EEG-fMRI for noninvasive measurement of brain dynamics includes mesoscale mapping at ultrahigh magnetic resonance fields, targeted perturbation-based neuroimaging, and using deep learning to uncover nonlinear representations that link the electrophysiological and hemodynamic measurements.