bluuebunny/crossref_metadata_2025 huggingface dataset:
Reducing Carbon Intensity of Production & Improving Uptime by Use of an Electric Adaptive Gas Lift Compressor
Authors: Rathore Devvrat , Snow John , Snow Paul
Published: November 2022

This paper details the framework and operation of a wellsite facility that utilizes a wellsite gas lift compressor that implements “adaptive flow control” to minimize manual intervention and carbon intensity of oil and gas production. The adaptive operation of the compression package is detailed, along with the metrics quantifying the reduction in carbon intensity. The basis for the reduction in carbon intensity is achieved by reduction in scope-1 emissions, instrumentation exhaust, minimizing the intervention by operations teams, and operating in “adaptive” mode to minimize trips and maximize production.

Unconventional wells on gas lift are sensitive to surface compressors trips, and in most cases required to be shut in a few hours due to liquid loading. Given the remoteness of well facilities, there may not be enough time for a lease operator or compressor technician to arrive at the compressor before the well is shut-in. Tracking the data on the majority causes of failures, it is observed that about half of the compressor trips were caused due to fluctuation in process gas pressure — this can be suction side, discharge side or due to gas conditions causing sudden fluctuation between stages of compression. Additionally, these dynamic conditions of operation are protected by static equipment protection alarms. The adaptive compressor operates with the ability to adjust to fluctuating process conditions, including floating shutdown limits using real-time calculation of mechanical loads on key components to ensure the dynamic nature of the shutdown limits does not impact equipment integrity. In case of a trip, the compressor additionally goes through a series of tests and attempts to restart itself. First trials of this project have shown high uptime of the facility and gas lift compressor and provide a model for collaborative R&D towards achieving a producers goals.
Zernike model for overlay control and tool monitor for lithography and etch process
Authors: Zhang Libin , Feng Yaobin , Song Zhen , Yang Shang , Wei Yayi
Published: November 2022

In advanced lithography and etch processes, the after-etch overlay is rendered unequal to the after-development overlay, and an etch process–induced overlay plays an extremely important role in determining the total overlay. This makes it difficult to achieve feedback control and also throws the overlay residue out of the control specifications. As the layer number of three dimensional integrated circuits increases or the overlay residue is only several nanometers in extreme ultraviolet technology, differentiations in etch tools lead to lot-to-lot overlay differences. Tool difference should be considered to compensate the overlay, irrespective of which method, interfield, intrafield, or correction per exposure (CPE), is used. However, it is not recommended to compensate the overlay for every lot as it will increase the cost of metrology. One of the widely used methods is to separate the lots by groups. In this paper, we propose a Zernike-CPE method to conduct a systematic study on how to reduce the overlay residue during the process of providing CPE feedback and to monitor tool performance. The research results demonstrate that the proposed method has potential roles to play in achieving overlay control and is highly suitable for advanced technology process monitoring.
Pandemic-Related Life Events and Physical Inactivity During COVID-19 Among Israeli Adults: The Smoking and Lifestyles in Israel Study
Authors: Shuval Kerem , Qadan Mahmoud , Leonard David , Barlow Carolyn E. , Drope Jeffrey , DiPietro Loretta , Oetjen Reid , Li Qing , DeFina Laura F.
Published: November 2022

Background: Public health measures to contain the COVID-19 pandemic have led to disruptions in daily life, such as job loss and changes in activity. The present study examines the relationship between pandemic-related life events and disuse (prolonged sitting coupled with inactivity) among adults. Methods: A cross-sectional study of 4084 adults in Israel (September 2020). The primary independent variables were pandemic-related life events, such as job loss. The primary dependent variable was disuse as measured by the Rapid Assessment Disuse Index (RADI). The RADI was examined continuously and dichotomously as a low RADI score (<26: yes/no). Results: Linear regression indicated that experiencing a major life event during the pandemic was associated with lower RADI scores (−1.03; 95% confidence interval, −1.47 to −0.60). Similarly, logistic regression revealed that those experiencing a major life event had 1.22 (95% confidence interval, 1.07 to 1.40) times greater odds for low RADI scores in comparison to those not experiencing an event. Conclusions: Experiencing pandemic-related major life events was linked to less sitting time and increased activity levels among Israeli adults. Future research should examine underlying mechanisms explaining this relationship to facilitate the design and implementation of targeted interventions.
If You Rebuild It, Will They Come? The Impact of Renovated Sports Facilities on Total Revenue and Attendance
Authors: Soebbing Brian P. , Seifried Chad S. , Tutka Patrick
Published: November 2022

The novelty effect has a long history in sport facility research with most research examining new facility construction. The present study explores the impact of renovated facilities, specifically the novelty effect, as it pertains to revenue and secondarily attendance. Within, we also explore four different renovation types as classified by the U.S. National Registry of Historic Places to look at any individual impact or revelation using institutions participating in the National Collegiate Athletic Association Division I Football Bowl Subdivision. Results from ordinary least squares and Tobit estimations from a sample period covering 1993 through 2017 conclude a novelty effect associated with renovations does exist for attendance. However, the effect is shorter in duration and delayed by a few seasons based upon the type of renovation. As for revenues, we find some positive impact on revenues. Those impacts are delayed are on based on certain types of renovation.
M
1
muscarinic receptor activation reduces the molecular pathology and slows the progression of prion-mediated neurodegenerative disease
Authors: Dwomoh Louis , Rossi Mario , Scarpa Miriam , Khajehali Elham , Molloy Colin , Herzyk Pawel , Mistry Shailesh N. , Bottrill Andrew R. , Sexton Patrick M. , Christopoulos Arthur , Conn P. Jeffrey , Lindsley Craig W. , Bradley Sophie J. , Tobin Andrew B.
Published: November 2022

Many dementias are propagated through the spread of “prion-like” misfolded proteins. This includes prion diseases themselves (such as Creutzfeldt-Jakob disease) and Alzheimer’s disease (AD), for which no treatments are available to slow or stop progression. The M
1
acetylcholine muscarinic receptor (M
1
receptor) is abundant in the brain, and its activity promotes cognitive function in preclinical models and in patients with AD. Here, we investigated whether activation of the M
1
receptor might slow the progression of neurodegeneration associated with prion-like misfolded protein in a mouse model of prion disease. Proteomic and transcriptomic analysis of the hippocampus revealed that this model had a molecular profile that was similar to that of human neurodegenerative diseases, including AD. Chronic enhancement of the activity of the M
1
receptor with the positive allosteric modulator (PAM) VU0486846 reduced the abundance of prion-induced molecular markers of neuroinflammation and mitochondrial dysregulation in the hippocampus and normalized the abundance of those associated with neurotransmission, including synaptic and postsynaptic signaling components. PAM treatment of prion-infected mice prolonged survival and maintained cognitive function. Thus, allosteric activation of M
1
receptors may reduce the severity of neurodegenerative diseases caused by the prion-like propagation of misfolded protein.
The type II TGF-β receptor phosphorylates Tyr
182
in the type I receptor to activate downstream Src signaling
Authors: Yakymovych Ihor , Yakymovych Mariya , Hamidi Anahita , Landström Maréne , Heldin Carl-Henrik
Published: November 2022

Transforming growth factor–β (TGF-β) signaling has important roles during embryonic development and in tissue homeostasis. TGF-β ligands exert cellular effects by binding to type I (TβRI) and type II (TβRII) receptors and inducing both SMAD-dependent and SMAD-independent intracellular signaling pathways, the latter of which includes the activation of the tyrosine kinase Src. We investigated the mechanism by which TGF-β stimulation activates Src in human and mouse cells. Before TGF-β stimulation, inactive Src was complexed with TβRII. Upon TGF-β1 stimulation, TβRII associated with and phosphorylated TβRI at Tyr
182
. Binding of Src to TβRI involved the interaction of the Src SH2 domain with phosphorylated Tyr
182
and the interaction of the Src SH3 domain with a proline-rich region in TβRI and led to the activation of Src kinase activity and Src autophosphorylation. TGF-β1–induced Src activation required the kinase activities of TβRII and Src but not that of TβRI. Activated Src also phosphorylated TβRI on several tyrosine residues, which may stabilize the binding of Src to the receptor. Src activation was required for the ability of TGF-β to induce fibronectin production and migration in human breast carcinoma cells and to induce α–smooth muscle actin and actin reorganization in mouse fibroblasts. Thus, TGF-β induces Src activation by stimulating a direct interaction with TβRI that depends on tyrosine phosphorylation of TβRI by TβRII.
Volatile Aroma Compound Production Is Affected by Growth Rate in S. cerevisiae
Authors: Visinoni Federico , Zhang Penghan , Hollywood Katherine A. , Carlin Silvia , Vrhovsek Urska , Winterburn James , Delneri Daniela
Published: November 2022

The production of fermentation beverages will need to quickly adapt to changes in both the climate and customer demands, requiring the development of new strains and processes. Breakthroughs in the field are hindered by the limited knowledge on the interplay between physiology and aroma compound production in yeast.
DNA Damage Response Signaling Is Crucial for Effective Chikungunya Virus Replication
Authors: Chatterjee Sanchari , Kumar Sameer , Mamidi Prabhudutta , Datey Ankita , Sengupta Soumya , Mahish Chandan , Laha Eshna , De Saikat , Keshry Supriya Suman , Nayak Tapas Kumar , Ghosh Soumyajit , Singh Sharad , Subudhi Bharat Bhusan , Chattopadhyay Subhasis , Chattopadhyay Soma
Published: November 2022

Being intracellular parasites, viruses require several host cell machineries for effectively replicating their genome, along with virus-encoded enzymes. One of the strategies involves hijacking of the DDR pathways.
Upregulation of ATF4-LAMP3 Axis by ORF45 Facilitates Lytic Replication of Kaposi’s Sarcoma-Associated Herpesvirus
Authors: Sun Qinqin , Wang Fan , Chen Qingyang , Sarid Ronit , Li Xiaojuan , Kuang Ersheng
Published: November 2022

The lytic replication of Kaposi’s sarcoma-associated herpesvirus (KSHV) reprograms cellular transcription and translation to generate viral proteins and virion particles. Here, we show that the mediator of ER stress ATF4 and the expression of the downstream gene LAMP3 are upregulated by ORF45 during lytic replication.
Unraveling the Pathobiological Role of the Fungal KEOPS Complex in Cryptococcus neoformans
Authors: Choi Yeseul , Jeong Eunji , Lee Dong-Gi , Jin Jae-Hyung , So Yee-Seul , Yu Seong-Ryong , Lee Kyung-Jo , Ha Yoonjie , Lin Chi-Jan , Chen Ying-Lien , Park Jun Bae , Cho Hyun-Soo , Averette Anna F. , Heitman Joseph , Lee Kyu-Ho , Lee Kangseok , Bahn Yong-Sun
Published: November 2022

The cellular function and structural configuration of the KEOPS complex have been elucidated in some eukaryotes and archaea but have never been fully characterized in fungal pathogens. Here, we comprehensively analyzed the pathobiological roles of the KEOPS complex in the globally prevalent fungal meningitis-causing pathogen
C. neoformans
.
Whole-Genome Sequences of Antibiotic-Resistant Trueperella pyogenes Isolates from Surgical Site Infections in Dairy Cows in Switzerland
Authors: Marchionatti Emma , Perreten Vincent
Published: November 2022

The complete genome sequence of four
Trueperella pyogenes
isolated from cattle surgical site infections in Switzerland was determined using hybrid assembly of Oxford Nanopore and Illumina reads. Genes conferring resistance to tetracyclines [
tet
(W)], sulfonamides (
sul1
), chloramphenicol (
cmx
), streptomycin/spectinomycin (
aadA1
), and quaternary ammonium compounds (
qacE
Δ
1
) were identified on different chromosomal elements.
A New Benzothiazolthiazolidine Derivative, 11726172, Is Active
In Vitro
,
In Vivo
, and against Nonreplicating Cells of Mycobacterium tuberculosis
Authors: Salina Elena G. , Postiglione Umberto , Chiarelli Laurent R. , Recchia Deborah , Záhorszká Monika , Lepioshkin Alexander , Monakhova Natalia , Pál Adrian , Porta Alessio , Zanoni Giuseppe , Korduláková Jana , Kazakova Elena , Sassera Davide , Pasca Maria Rosalia , Makarov Vadim , Degiacomi Giulia
Published: November 2022

The discontinuation of TB services due to COVID-19 causes concern about a future resurgence of TB, also considering that latent infection affects a high number of people worldwide. To combat this situation, the identification of antitubercular compounds targeting
Mycobacterium tuberculosis
through novel mechanisms of action is necessary.
Genetic Predictive Factors for Nonsusceptible Phenotypes and Multidrug Resistance in Expanded-Spectrum Cephalosporin-Resistant Uropathogenic Escherichia coli from a Multicenter Cohort: Insights into the Phenotypic and Genetic Basis of Coresistance
Authors: Jackson Nicole , Belmont Cheyenne R. , Tarlton Nicole J. , Allegretti Yuan Hu , Adams-Sapper Sheila , Huang Yolanda Yue , Borges Clarissa A. , Frazee Bradley W. , Florence-Petrovic Danka , Hufana Clarisse , Parker Anna , Mastrangelo Claire F. , Awasthi Shevya , Kane Isha , Coralic Zlatan , Miller Steve , Diaz Joycelyn , Fee Christopher , Bittencourt Cassiana E. , Garner Omai , Chandrasekaran Sukantha , Crandall Claudia , Marcha Julian C. , Noorbakhsh Mir H. , Rodrigues-Wong Patricia , deBoer Tara R. , Riley Lee W.
Published: November 2022

The rising incidence of resistance to expanded-spectrum cephalosporins among
Escherichia coli
strains, the most common cause of UTIs, is threatening our ability to successfully empirically treat these infections. ESCR
E. coli
strains are often MDR; therefore, UTI caused by these organisms often leads to treatment failure, increased length of hospital stay, and severe complications (D. G. Mark, Y.-Y. Hung, Z. Salim, N. J. Tarlton, et al., Ann Emerg Med 78:357–369, 2021,
https://doi.org/10.1016/j.annemergmed.2021.01.003
).
Metabolic Potential of Microbial Communities in the Hypersaline Sediments of the Bonneville Salt Flats
Authors: McGonigle Julia M. , Bernau Jeremiah A. , Bowen Brenda B. , Brazelton William J.
Published: November 2022

The Bonneville Salt Flats is a unique ecosystem created from 10,000 years of desiccation and serves as an important natural laboratory for the investigation of the habitability of salty, halite, and gypsum-rich environments. Here, we show that gypsum-rich mineral deposits host a surprising diversity of organisms and appear to play a key role in stimulating the microbial cycling of sulfur and nitrogen compounds.
TaxiBGC: a Taxonomy-Guided Approach for Profiling Experimentally Characterized Microbial Biosynthetic Gene Clusters and Secondary Metabolite Production Potential in Metagenomes
Authors: Gupta Vinod K. , Bakshi Utpal , Chang Daniel , Lee Aileen R. , Davis John M. , Chandrasekaran Sriram , Jin Yong-Su , Freeman Michael F. , Sung Jaeyun
Published: November 2022

Currently available bioinformatics tools to identify BGCs from metagenomic sequencing data are limited in their predictive capability or ease of use to even computationally oriented researchers. We present an automated computational pipeline called TaxiBGC, which predicts experimentally characterized BGCs (and infers their known SMs) in shotgun metagenomes by first considering the microbial species source.
Changes in the Microbial Structure of the Root Soil and the Yield of Chinese Baby Cabbage by Chemical Fertilizer Reduction with Bio-Organic Fertilizer Application
Authors: Jin Li , Jin Ning , Wang Shuya , Li Jinwu , Meng Xin , Xie Yandong , Wu Yue , Luo Shilei , Lyu Jian , Yu Jihua
Published: November 2022

Chemical fertilizers are commonly used for agriculture, though bio-organic fertilizers may be more efficient. We found that a mixture of bio-organic and moderately reduced chemical fertilizer was more effective than chemical fertilizer alone, as it raised the Chinese baby cabbage yield.
Two Different Phospholipases C, Isc1 and Pgc1, Cooperate To Regulate Mitochondrial Function
Authors: Balazova Maria , Vesela Petra , Babelova Lenka , Durisova Ivana , Kanovicova Paulina , Zahumensky Jakub , Malinsky Jan
Published: November 2022

In eukaryotic cells, mitochondria are constantly adapting to changes in the biological activity of the cell, i.e., changes in nutrient availability and environmental stresses. We propose a model in which this adaptation is mediated by lipids.
An Optimized Screening Approach for the Oxazolidinone Resistance Gene
optrA
Yielded a Higher Fecal Carriage Rate among Healthy Individuals in Hangzhou, China
Authors: Shen Weiyi , Huang Yonglu , Cai Jiachang
Published: November 2022

This study represented an optimized screening approach for the
optrA
gene, which is an important mechanism of antimicrobial resistance to linezolid as a last resort for the treatment of infections caused by multiresistant Gram-positive bacteria. We revealed a high fecal carriage rate of the
optrA
gene among adults by this method and reported the first identification of
optrA
in
Lactococcus formosensis
as well as the identification of this gene in
Vagococcus lutrae
and of the
poxtA
gene in
Ligilactobacillus salivarius
of human origin, suggesting the wide spread of the
optrA
gene in the Gram-positive bacterial community.
Efficacy and Safety of Treatments for Different Stages of Syphilis: a Systematic Review and Network Meta-Analysis of Randomized Controlled Trials and Observational Studies
Authors: Liu Meixiao , Fan Yuxin , Chen Jingjing , Yang Jiaru , Gao Li , Wu Xinya , Xu Xin , Zhang Yu , Yue Peng , Cao Wenjing , Ji Zhenhua , Su Xuan , Wen Shiyuan , Kong Jing , Zhou Guozhong , Li Bingxue , Dong Yan , Liu Aihua , Bao Fukai
Published: November 2022

Parenteral penicillin is the first-line regimen for syphilis treatment. However, allergic reactions and poor drug tolerance still present emerging threatening problems with respect to use of this antibiotic.
Late Cretaceous−early Paleogene rise of the Gangdese magmatic arc (south Tibet) from sea level to high mountains
Authors: Xu Qiang , Ding Lin , Cao Yu , Cai Fulong , Li Shun , Tan Xiucheng , Kershaw Stephen , Tang Hao
Published: November 2022

Recognition of the existence of an Andean-type continental margin in southern Tibet prior to its collision with India has provided crucial constraints on the formation of the Tibetan Plateau and South Asian climate evolution. Here, we focused on well-dated Late Cretaceous successions in the Linzhou Basin and determined the elevation changes from sea level to high mountains in the Gangdese magmatic arc in southern Tibet. Our results show that the Linzhou Basin was still submerged in the Tethyan Sea at around 92 Ma when it accumulated Cenomanian (ca. 105−92 Ma) shallow-marine orbitolinid-bearing limestones (Takena Formation); these limestones are unconformably overlain by Campanian (83−78 Ma) fluvial-lacustrine deposits (Shexing Formation) after an ∼9 m.y. depositional hiatus. A prominent unconformity between the tightly folded Shexing Formation and gently tilted overlying Paleocene−Eocene Linzizong successions represents the formation of the regional Lhasaplano ca. 70 Ma, which may have been linked to the rise of an Andean-type Gangdese mountain range along the southern margin of the Lhasa terrane. Using carbonate oxygen isotope and clumped isotope thermometry data from the Shexing Formation paleosols, we quantitatively documented the rise of the Andean-type Gangdese Mountains with a peneplain surface at an elevation of 2.7 +0.5/−0.9 km above sea level prior to onset of the India-Asia collision ca. 65−63 Ma. This scenario of surface gain may have been an isostatic compensation response to the crust thickening to over 50 km during the Late Cretaceous. Subsequently, the surface isostatically rose to its near-present elevation of ∼4.6 km due to the removal of overthickened mantle lithosphere and revival of intense Gangdese magmatism by 56 Ma.
Familial amyloidosis of the Finnish type: clinical and neurophysiological features of two index cases
Authors: Antunes Cunha Inês , Brás Ana , Silva Fátima , Matos Anabela
Published: November 2022

Familial amyloidosis of the Finnish type (FAF) is a rare multisystemic disorder caused by mutations in the gelsolin gene. The clinical presentation is typically characterised by a triad of ophthalmic, neurological and dermatological findings. FAF has been reported in several countries, primarily in Finland and recently in Portugal. We report the first genetically confirmed cases of FAF from two unrelated families in our neuromuscular outpatient clinic. Gelsolin gene sequencing revealed the heterozygous gelsolin mutation (c.640G>A). The clinical features and the neurophysiological studies of two index patients and their relatives are presented. Obtaining an early diagnosis can be challenging, but FAF should be considered in the differential diagnosis of progressive bilateral facial neuropathy, even if there is no known Finnish ancestor.
Refractory paraneoplastic hypercalcaemia responding to cinacalcet
Authors: Shah Preet Mukesh , Rasool Irum , Maguire Deirdre
Published: November 2022

A woman in her late 70s presented with an increased frequency of micturition, suprapubic pain and weight loss. She was found to be having advanced cancer of the urinary bladder, coupled with bilateral hydronephrosis.Whilst undergoing surgical intervention for the latter, she was incidentally found to be having hypercalcaemia. This was found to be paraneoplastic in nature, possibly due to elevated parathyroid hormone related peptide with no evidence of bone metastasis. The histology of the resected tumour revealed squamous and sarcomatoid differentiation. Her hypercalcaemia initially responded to intravenous fluids, and later on zolendronate,but the problem recurred again, with the response to a repeat dose of zolendronate and even denosumab being unsatisfactory. As a last resort cinacalcet was started, and although there was a good response to it, our patient sadly died a few weeks later.

We believe our case to be the first case of hypercalcaemia associated with isolated bladder cancer which showed a successful response to cinacalcet.
Left atrial appendage occlusion with Watchman device after incomplete surgical ligation
Authors: Manongi Ngoda , Volodarskiy Alexander , Goldbarg Seth
Published: November 2022

Non-valvular atrial fibrillation (NVAF) is the most common cause of cardioembolic stroke. The left atrial appendage (LAA) is the major source of cardiac emboli in patients with NVAF. Anticoagulation (AC) is the standard of care for stroke prevention in atrial fibrillation (AF), but many patients are intolerant of AC. Surgical exclusion of the LAA may result in incomplete closure and is associated with an increased risk of embolism. We report a case of a woman in her 50s with a history of persistent AF, mitral valve prolapse s/p repair with surgical LAA exclusion, and multifocal haemorrhagic stroke presented for elective LAA closure who underwent a Watchman placement successfully. This case demonstrates that a percutaneous approach for occlusion of the LAA when surgical exclusion was incomplete may be feasible with appropriate planning. Clinical outcome data for this patient group are needed.
A Novel approach using O-CVP to treat paraneoplastic NMO spectrum disorder associated with follicular lymphoma
Authors: Palmer David Antony , Dooley Hannah , Pipis Menelaos , Patten Piers , Silber Eli
Published: November 2022

Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune neuroinflammatory disorder of the central nervous system that very rarely may be a paraneoplastic phenomenon. We describe the case of a woman with a longitudinally extensive transverse myelitis (LETM). We identified a previously undiagnosed, follicular lymphoma and she was treated with the immunochemotherapy regime (obinutuzumab, cyclophosphamide, vincristine and prednisolone; O-CVP) for paraneoplastic NMOSD. Following two cycles, there was almost complete radiological remission of the myelitis and the patient showed some improvement in her neurological function. This case illustrates the heterogeneous aetiology that LETM may have and that O-CVP may be used as therapeutic option in patients with NMOSD driven by follicular lymphoma.
Add-on imeglimin versus metformin dose escalation regarding glycemic control in patients with type 2 diabetes treated with a dipeptidyl peptidase-4 inhibitor plus low-dose metformin: study protocol for a multicenter, prospective, randomized, open-label, parallel-group comparison study (MEGMI study)
Authors: Nomoto Hiroshi , Takahashi Akihiro , Nakamura Akinobu , Kurihara Hiroyoshi , Takeuchi Jun , Nagai So , Taneda Shinji , Miya Aika , Kameda Hiraku , Cho Kyu Yong , Miyoshi Hideaki , Atsumi Tatsuya
Published: November 2022

Introduction

Imeglimin is a novel anti-hyperglycemic drug that improves both insulin resistance and insulin secretion. The effects of imeglimin on glycemic control were confirmed in phase III clinical trials, but little is known about its effectiveness in daily clinical practice settings, especially compared with metformin. Therefore, we aim to clarify the efficacy of imeglimin in patients with type 2 diabetes (T2D) being treated with a dipeptidyl peptidase-4 (DPP-4) inhibitor plus low-dose metformin.

Research design and methods

This is a multicenter, randomized, prospective, open-label, parallel-group trial. Seventy participants with T2D treated with a DPP-4 inhibitor plus metformin (500–1000 mg/day) for more than 12 weeks and a glycated hemoglobin (HbA1c) level of 52–85 mmol/mol (7.0%–9.9%) will be randomized to receive add-on imeglimin 1000 mg two times per day or metformin dose escalation for 24 weeks. Biochemical analyses and physical assessments will be performed at baseline and at the end of the study, and adverse events will be recorded. The primary endpoint is the change in HbA1c after 24 weeks. The secondary endpoints comprise the changes in blood pressure, pulse rate, body weight, abdominal circumference, and other laboratory parameters; the relationship between improvements of biological parameters including glycemic control and patient background characteristics; and side effects.

Results

This study will reveal new insights into the incorporation of imeglimin into the diabetes treatment strategy.

Conclusions

This will be the first randomized controlled trial to compare the efficacy of adding imeglimin versus metformin dose escalation on glycemic control in patients with T2D.

Trial registration number

jRCT1011220005.
Challenges of epidemiological investigation work in the COVID-19 pandemic: a qualitative study of the epidemiology workforce in Guangdong Province, China
Authors: Zheng Peng , Li Cuizhi , Zhang Hongyue , Huang Bing , Zhang Yue , Feng Huiyao , Jiang Diwei , Chen Xiongfei , Dong Xiaomei
Published: November 2022

Objectives

This study sought to identify the epidemiological investigation challenges of the COVID-19 pandemic and offer insights into the underlying issues.

Design

An exploratory qualitative study used thematic analysis of semistructured and in-depth individual interviews.

Setting

This study was conducted in Centers for Disease Control and Prevention in Guangdong Province.

Participants

Twenty-four participants consented to participate in an in-depth interview. Transcribed recordings were managed using NVivo software and analysed using inductive thematic analysis.

Results

The qualitative analysis revealed five key themes: high-intensity epidemiological investigation task, emergency management requiring improvement in the early stage, respondent uncertainty, impact on work and social life and inadequate early-stage Joint Prevention and Control Mechanism.

Conclusion

This survey focuses on the epidemiology workforce at the forefront of the COVID-19 pandemic and qualitatively describes their experiences, vocational issues and psychological stressors. We found that the problems of epidemiological investigation posed intense challenges to the epidemiology workforce. These findings highlight the epidemiological investigation challenges associated with this pandemic. We have provided some suggestions that may help improve the efficiency and quality of the epidemiology workforce in China.
Patients’ experience of and participation in a stroke self-management programme, My Life After Stroke (MLAS): a multimethod study
Authors: Blatchford Emily Grace , Aquino Maria Raisa Jessica , Grant Julie , Johnson Vicki , Mullis Ricky , Lim Lisa , Mant Jonathan
Published: November 2022

Objective

A self-management programme, My Life After Stroke (MLAS), was developed to support stroke survivors. This evaluation reports patients’ experience.

Design

Multimethod, involving interviews and questionnaires.

Setting

23 general practices in the intervention arm of a cluster randomised controlled trial in East of England and East Midlands, UK.

Participants

People on the stroke registers of participating general practices were invited to attend an MLAS programme.

Interventions

MLAS comprises one-to-one and group-based sessions to promote independence, confidence and hope.

Primary and secondary outcome measures

The primary outcome was uptake of the programme. Participants who declined MLAS were sent a questionnaire to ascertain why. Attendees of four programmes completed evaluation forms. Attendees and non-attendees of MLAS were interviewed. Ad-hoc email conversations with the lead author were reviewed. Thematic analysis was used for qualitative data.

Results

141/420 (34%) participants (mean age 71) attended an MLAS programme and 103 (73%) completed 1. 64/228 (28%) participants who declined MLAS gave reasons as: good recovery, ongoing health issues, logistical issues and inappropriate. Nearly all attendees who completed questionnaires felt that process criteria such as talking about their stroke and outcomes such as developing a strong understanding of stroke had been achieved.

Conclusions

MLAS was a positive experience for participants but many stroke survivors did not feel it was appropriate for them. Participation in self-management programmes after stroke might be improved by offering them sooner after the stroke and providing a range of delivery options beyond group-based, face-to-face learning.

Trial registration number

NCT03353519, NIH.
Antenatal depression and its associated factors among women of Godawari Municipality, Lalitpur, Nepal: a cross-sectional study
Authors: Chalise Anisha , Shrestha Gambhir , Paudel Shishir , Poudyal Amod Kumar
Published: November 2022

Objectives

To estimate the prevalence of antenatal depression and identify its associated factors among pregnant women of Godawari Municipality, Lalitpur, Nepal.

Design

Community-based cross-sectional study.

Setting

Godawari Municipality, Lalitpur, Nepal, between September and November 2021.

Participants

250 randomly selected pregnant women of Godawari Municipality, Lalitpur, Nepal.

Main outcome measures

The level of antenatal depression was assessed using Edinburgh Postnatal Depression Scale. χ2test and multivariate logistic regression analysis were applied to determine the association between antenatal depression and related variables at 95% level of confidence.

Results

The prevalence of antenatal depression was found to be 24.8% (95% CI: 19.2 to 30.7). Multigravida (AOR: 2.219, 95% CI: 1.113 to 4.423), unintended pregnancy (AOR: 2.547, 95% CI: 1.204 to 5.388), male sex preference of child by family (AOR: 2.531, 95% CI: 1.204 to 5.321) and intimate partner violence (AOR: 2.276, 95% CI: 1.116 to 4.640) were found to be the positive predictors of antenatal depression.

Conclusion

This study showed a high prevalence of depression among pregnant women. The results suggest a need for mental health assessment during pregnancy. Screening for depression should be part of routine antenatal checkups for early detection and management of mental health concerns during this vulnerable period.
Paediatric dengue shock syndrome and acute respiratory failure: a single-centre retrospective study
Authors: Preeprem Nutnicha , Phumeetham Suwannee
Published: November 2022

Objective

Dengue shock syndrome (DSS) is a serious health condition leading to paediatric intensive care unit (PICU) admissions and deaths in tropical countries. Acute respiratory failure (ARF) is associated with DSS and is a major cause of dengue deaths. We aimed to identify risk factors associated with ARF in children with DSS.

Methods

We retrospectively reviewed children with DSS admitted to a PICU from 2010 to 2020 at a tertiary level hospital in Bangkok, Thailand. Patient characteristics, clinical parameters and laboratory data were collected. Multivariable logistic regression analysis was used to identify factors associated with ARF.

Results

Twenty-six (43.3%) of 60 children with DSS developed ARF and 6 did not survive to day 28. The median (IQR) age was 8.1 years (IQR 4.0–11.0). Fluid accumulation during the first 72 hours of PICU admission was greater in the ARF group compared with the non-ARF group (12.2% (IQR 7.6–21.7) vs 8.3% (IQR 4.4–13.3), p=0.009). In a multivariate analysis at 72 hours post PICU admission, the presence of ˃15% fluid accumulation was independently associated with ARF (adjusted OR 5.67, 95% CI 1.24 to 25.89, p=0.025).

Conclusion

ARF is an important complication in children with DSS. A close assessment of patient fluid status is essential to identify patients at risk of ARF. Once the patient is haemodynamically stable and leakage slows, judicious fluid management is required to prevent ARF.
Towards NHS Zero: greener gastroenterology and the impact of virtual clinics on carbon emissions and patient outcomes. A multisite, observational, cross-sectional study.
Authors: King Jonathan , Poo Stephanie X , El-Sayed Ahmed , Kabir Misha , Hiner George , Olabinan Olaolu , Colwill Michael , Ayubi Homira ,   GLINT Research Network, Shakweh Eathar , Kronsten Victoria T , Kader Rawen , Hayee Bu'Hussain
Published: November 2022

Objective

The National Health Service (NHS) produces more carbon emissions than any public sector organisation in England. In 2020, it became the first health service worldwide to commit to becoming carbon net zero, the same year as the COVID-19 pandemic forced healthcare systems globally to rapidly adapt service delivery. As part of this, outpatient appointments became largely remote. Although the environmental benefit of this change may seem intuitive the impact on patient outcomes must remain a priority. Previous studies have evaluated the impact of telemedicine on emission reduction and patient outcomes but never before in the gastroenterology outpatient setting.

Method

2140 appointments from general gastroenterology clinics across 11 Trusts were retrospectively analysed prior to and during the pandemic. 100 consecutive appointments during two periods of time, from 1 June 2019 (prepandemic) to 1 June 2020 (during the pandemic), were used. Patients were telephoned to confirm the mode of transport used to attend their appointment and electronic patient records reviewed to assess did-not-attend (DNA) rates, 90-day admission rates and 90-day mortality rates.

Results

Remote consultations greatly reduced the carbon emissions associated with each appointment. Although more patients DNA their remote consultations and doctors more frequently requested follow-up blood tests when reviewing patients face-to-face, there was no significant difference in patient 90-day admissions or mortality when consultations were remote.

Conclusion

Teleconsultations can provide patients with a flexible and safe means of being reviewed in outpatient clinics while simultaneously having a major impact on the reduction of carbon emissions created by the NHS.
BSG cross-sectional survey on impact of COVID-19 recovery on workforce, workload and well-being
Authors: Kabir Misha , Matharoo Manmeet , Dhar Anjan , Gordon Harriet , King Jonathan , Lockett Melanie , Morris Danielle , Moroni Francesca , Patel Nisha , Verma Ajay Mark , Samji Shairoz
Published: November 2022

Objective

The aim of this survey was to understand the impact of the COVID-19 pandemic and recovery phase on workload, well-being and workforce attrition in UK gastroenterology and hepatology.

Design/method

A cross-sectional survey of British Society of Gastroenterology physician and trainee members was conducted between August and October 2021. Multivariable binary logistic regression and qualitative analyses were performed.

Results

The response rate was 28.8% (180/624 of opened email invites). 38.2% (n=21/55) of those who contracted COVID-19 felt pressured to return to work before they felt ready. 43.8% (71/162) had a regular increase in out-of-hours working. This disproportionately affected newly appointed consultants (OR 5.8), those working full-time (OR 11.6), those who developed COVID-19 (OR 4.1) and those planning early retirement (OR 4.0). 92% (150/164) believe the workforce is inadequate to manage the service backlog with new consultants expressing the highest levels of anxiety over this. 49.1% (80/163) felt isolated due to remote working and 65.9% (108/164) felt reduced face-to-face patient contact made their job less fulfilling. 34.0% (55/162) planned to work more flexibly and 54.3% (75/138) of consultants planned to retire early in the aftermath of the pandemic. Early retirement was independently associated with male gender (OR 2.5), feeling isolated from the department (OR 2.3) and increased anxiety over service backlog (OR 1.02).

Conclusion

The pandemic has placed an additional burden on work-life balance, well-being and workforce retention within gastroenterology and hepatology. Increased aspirations for early retirement and flexible working need to be explicitly addressed in future workforce planning.
National Institute for Health and Care Excellence guidelines for lipid management
Authors: Cegla Jaimini
Published: November 2022

This article provides a summary of the available lipid-lowering therapies in the UK and how they fit into national guidelines. In addition, comparison is made between the current National Institute for Health and Care Excellence lipid modification guidelines and international guidance such as those published by the European Society of Cardiology/European Atherosclerosis Society and American Heart Association/American College of Cardiology.
Sex differences in onset to hospital arrival time, prestroke disability, and clinical symptoms in patients with a large vessel occlusion: a MR CLEAN Registry substudy
Authors: Ali Mariam , van der Meij Anne , van Os Hendrikus J A , Ali Mahsoem , Van Zwet Erik W , Spaander Fianne H M , Hofmeijer Jeanette , Nederkoorn Paul J , van den Wijngaard Ido R , Majoie Charles B L M , van Es Adriaan C G M , Schonewille Wouter J , van Walderveen Marianne A A , Dippel Diederik W J , Visser Marieke C , Kruyt Nyika D , Wermer Marieke J H
Published: November 2022

Background

Women have been reported to have worse outcomes after endovascular treatment (EVT), despite a similar treatment effect in non-clinical trial populations. We aimed to assess sex differences at hospital presentation with respect to workflow metrics, prestroke disability, and presenting clinical symptoms.

Methods

We included consecutive patients from the Multicentre Randomised Controlled Trial of Endovascular Treatment for Acute Ischaemic Stroke in The Netherlands (MR CLEAN) Registry (2014–2018) who received EVT for anterior circulation large vessel occlusion (LVO). We assessed sex differences in workflow metrics, prestroke disability (modified Rankin Scale (mRS) score ≥1), and stroke severity and symptoms according to the National Institutes of Health Stroke Scale (NIHSS) score on hospital admission with logistic and linear regression analyses and calculated the adjusted OR (aOR).

Results

We included 4872 patients (47.6% women). Compared with men, women were older (median age 76 vs 70 years) and less often achieved good functional outcome at 90 days (mRS ≤2: 35.2% vs 46.4%, aOR 0.70, 95% CI 0.60 to 0.82). Mean onset-to-door time was longer in women (2 hours 16 min vs 2 hours 7 min, adjusted delay 9 min, 95% CI 4 to 13). This delay contributed to longer onset-to-groin times (3 hours 26 min in women vs 3 hours 13 min in men, adjusted delay 13 min, 95% CI 9 to 17). Women more often had prestroke disability (mRS ≥1: 41.1% vs 29.1%, aOR 1.57, 95% CI 1.36 to 1.82). NIHSS on admission was essentially similar in men and women (mean 15±6 vs 15±6, NIHSS <10 vs ≥10, aOR 0.91, 95% CI 0.78 to 1.06). There were no clear sex differences in the occurrence of specific stroke symptoms.

Conclusion

Women with LVO had longer onset-to-door times and more often prestroke disability than men. Raising awareness of these differences at hospital presentation and investigating underlying causes may help to improve outcome after EVT in women.
Parkinson’s disease and palliative care: a quality of care Delphi study
Authors: Rogers Alice , Richfield Edward William , Thomas Sue , Wee Bee , Trotter Sophie Anne
Published: November 2022

Objectives

Extending palliative care services to those with long-term neurological conditions is a current aim of UK health policy. Lack of holistic guidelines for palliative and end-of-life care, and differing models of service provision, has resulted in heterogeneity in care access and quality. There is a need for evidence-based standards of care to audit Parkinson’s services and drive improvements.

Methods

A two-stage Delphi process was used to achieve consensus on statements that define quality standards in palliative care for patients with Parkinson’s disease (PD). An expert panel was selected to comprise healthcare professionals, patients and carers based in the UK; this panel evaluated the statements via a Delphi survey. Quantitative and qualitative analysis of the results informed modifications between the Delphi rounds.

Results

A final set of 16 statements was produced, reflecting aspirational standards of palliative care in PD. These statements, split into four domains (‘Structures and processes of care’, ‘Preparing for the end of life’, ‘ Care in the last weeks of life’ and ‘Care in the last days of life’) underline the importance of joint working between generalist and specialist services, individualised care and early and regular advance care planning.

Conclusions

The Delphi process has established a set of standards which can be integrated within and guide services, helping to improve the quality and equality of care. Further work remains to establish the effectiveness of different models of service provision, including the implementation of keyworkers and telemedicine.
Central anticholinergic syndrome from hyoscine hydrobromide in an unresponsive patient
Authors: Murphy David , Waldron Dympna , Kennedy Grace , Molony Jack
Published: November 2022

Terminal agitation is common and causes severe distress for patients and loved ones. Careful assessment is of paramount importance in identifying a cause. PA patient with gastric adenocarcinoma who was admitted with adverse effects post-chemotherapy deteriorated acutely with a presumed intracerebral event. Secretions were an issue and hyoscine hydrobromide was commenced. Within twenty-four hours, the patient became acutely agitated and did not respond to standard treatment.After careful clinical examination out-ruling other causes, toxic psychosis secondary to hyoscine hydrobromide was felt to be most likely. Rotating anti-secretories and commencing a phenobarbitone infusion to treat severe agitation resulted in prolonged comfort before death.Inhibiting cholinergic transmission at central muscarinic receptors can cause psychosis, delirium, etc. Hyoscine hydrobromide crosses the blood brain barrier. This case demonstrates that even in unresponsive patients, it may cause agitation. If standard therapies are failing to control agitation, all possibilities must be considered. Central side effects of hyoscine hydrobromide may be a rare but under-recognised cause of agitation. This case demonstrates how through careful clinical assessment of possible differentials, and prompt and effective management of the most likely causes of distress, lasting comfort can be achieved. Patient with gastric adenocarcinoma who was admitted with adverse effects post-chemotherapy deteriorated acutely with a presumed intracerebral event. Secretions were an issue and hyoscine hydrobromide was commenced. Within twenty-four hours, the patient became acutely agitated and did not respond to standard treatment.
An update on the seismic categorization for seismic risk assessment of existing Canadian buildings
Authors: Motazedian Dariush , Fathi-Fazl Reza , Cai Zhen , Fazileh Farrokh
Published: November 2022

An investigation has been done to update key input parameters in the recent seismic-risk-screening tools developed by the National Research Council Canada for the six seismic categories. In this study, the seismic categorization system in the recent seismic-risk-screening tools of the National Research Council Canada is extended to include Canadian buildings abroad by including threshold peak ground acceleration values, a more global set of modified Mercalli intensity, peak ground acceleration, and spectral response acceleration and peak ground acceleration relationships. The relationships among spectral response acceleration, peak ground acceleration, and peak ground velocity values have been derived using least-squares regression analyses to obtain the threshold values of both peak values associated with various modified Mercalli intensity values for each seismic category. Based on the updated relationships, the seismic categorization system is applied to 679 locations in Canada and 226 locations outside Canada.
Metabolic rate and osmoregulation in desert spring amphipods
Authors: Burns McKenna P.A. , Schaeffer Paul J. , Berg David J.
Published: November 2022

Desert springs contain many endemic taxa and are of conservation concern due to anthropogenic activities that are expected to increase environmental salinity. Understanding the nature of osmoregulation is necessary to predict how non-vagile aquatic organisms will respond to changes. In the Chihuahuan Desert, the amphipod genus Gammarus Fabricius, 1775 is composed of two lineages. These lineages have species that currently inhabit springs ranging from 0.4 to 7.8 parts per thousand (ppt). All Gammarus in this region are of conservation concern because each is endemic to a single spring system. We exposed individuals of Gammarus colei Walters, Cannizzaro, and Berg in Walters, Cannizzaro, Trujillo and Berg, 2020 and Gammarus seideli Cannizzaro, Walters and Berg, 2018 species occupying low-salinity springs, to the range of salinities found in the Chihuahuan Desert. We measured metabolic rates as [Formula: see text] to examine the energetic cost of osmoregulation. We also measured the hemolymph osmolality of G. colei and compared that with the isosmotic line to determine the degree of osmoregulation. Neither species increased its metabolic rate across increasing salinities. However, G. colei showed an increase in hemolymph osmolality. Despite the divergence (∼66 million years ago) between the two lineages, it appears their physiological tolerances have converged, suggesting that both lineages may be able to persist when exposed to moderate salinity changes.