bluuebunny/crossref_metadata_2025 huggingface dataset:
Longitudinal assessment of adhesion to vascular cell adhesion molecule‐1 at steady state and during vaso‐occlusive crises in sickle cell disease
Authors: White Jennell , Callaghan Michael U. , Gao Xiufeng , Liu Ke , Zaidi Ahmar , Tarasev Michael , Hines Patrick C.
Published: December 2021

Sickle cell disease (SCD) is characterized by frequent and unpredictable vaso‐occlusive crises (VOCs). Sickle erythrocytes (SSRBCs) contribute to VOCs by participating in a series of adhesive events with blood cells and the vascular endothelium. Adhesion assays have been used to evaluate the relationship between SSRBC adhesion and SCD severity. We developed a standardized, clinical flow adhesion assay of whole blood to vascular cell adhesion molecule (FA‐WB‐VCAM). The objective of this study was to assess the variability and clinical predictive value of FA‐WB‐VCAM in a six‐month longitudinal, observational study (ELIPSIS) in SCD subjects during at‐home, steady‐state and self‐reported VOCs, and following VOC resolution. We observed a strong relationship between FA‐WB‐VCAM and SCD severity. Adhesion indices were significantly lower in SCD subjects on hydroxycarbamide and increased during VOCs; at‐home VOCs had significantly higher FA‐WB‐VCAM than steady‐state and contact VOCs. SCD subjects with a high frequency of self‐reported VOCs had a pro‐adhesive phenotype at steady state and were stratified into a high‐adhesive phenotype cohort; two years prospectively we observed a higher frequency of VOCs in the high‐adhesion cohort. This study supports stratifying SCD subjects based on steady‐state FA‐WB‐VCAM and suggests that FA‐WB‐VCAM may be a plausible surrogate end‐point for SCD severity.
Airway complications in lung transplant recipients with telomere‐related interstitial lung disease
Authors: Choi Bina , Messika Jonathan , Courtwright Andrew , Mornex Jean François , Hirschi Sandrine , Roux Antoine , Le Pavec Jérôme , Quêtant Sébastien , Froidure Antoine , Lazor Romain , Reynaud‐Gaubert Martine , Borgne Aurélie Le , Houlbracq Mathilde Phillips , Goldberg Hilary , El‐Chemaly Souheil , Borie Raphael ,   French Group of Lung Transplantation
Published: December 2021

Introduction

Patients with short telomere‐related interstitial lung disease (ILD) have worse outcomes after lung transplantation. We hypothesized that post‐transplant airway complications, including dehiscence and bronchial stenosis, would be more common in the short telomere ILD lung transplant population.

Methods

We conducted a multi‐institutional (Brigham and Women's Hospital, Groupe de Transplantation de la SPLF) retrospective cohort study of 63 recipients between 2009 and 2019 with ILD and short telomeres, compared to 4359 recipients from the Scientific Registry of Transplant Recipients with ILD and no known telomeropathy.

Results

In the short telomere cohort, six recipients (9.5%) developed dehiscence and nine recipients (14.3%) developed stenosis, compared to 60 (1.4%) and 149 (3.4%) in the control, respectively. After adjusting for age, sex, and bilaterality, the presence of short telomeres was associated with higher odds of dehiscence (odds ratio (OR) = 8.24, 95% confidence interval (CI) = 3.34 20.29, p < .001) and stenosis (OR = 4.63, 95% CI 2.21 9.69, p < .001).

Conclusion

The association between the presence of short telomeres and post‐transplant dehiscence and stenosis suggest that airway complications may be a contributor to increased morbidity and mortality in patients with telomere‐related ILD.
Does aggressive tweeting by the government help to control the COVID‐19 outbreak? Evidence from China
Authors: Zheng Shilin , Li Mengdan
Published: December 2021

This paper estimates the role of the usage of the largest social media platform in China, Sina Weibo, by the Chinese government for controlling the COVID‐19 pandemic. Manually collected governmental microblogs about the COVID‐19 outbreak were analysed, which showed that a 10 per cent increase in the number of microblogs resulted in a 1.38 per cent decrease of confirmed COVID‐19 cases. This effect was more pronounced in areas with less restrained travel restrictions. The effect relies primarily on two mechanisms: encouraging home quarantine and promoting knowledge about COVID‐19 prevention.
Identification of a 16SrIX‐B phytoplasma strain associated with Daphne mucronata phyllody in Iran
Authors: Babaei Ghobad , Esmaeilzadeh‐Hosseini Seyyed Alireza , Shirmardi Hamzeh Ali , Bertaccini Assunta
Published: December 2021

During surveys from 2017 to 2018, a phyllody disease was observed in Daphne mucronata plants located in Lordegan and Ahmadliveh areas in Chaharmahal and Bakhtiari province (west of Iran). The main symptoms were yellowing, little leaf, phyllody and flower sterility. Total DNA was extracted from midrib tissue of fresh leaves from 30 symptomatic and five asymptomatic plants. DNA samples were subjected to nested PCR, using primer pairs P1/P7 and R16F2n/R16R2. PCR amplicons of 1.8 and 1.25 kb, respectively, were obtained from all samples from symptomatic plants whilst no amplification was observed in samples from asymptomatic plants. Restriction fragment length polymorphism (RFLP) analysis of R16F2n/R16R2 amplicons using MseI, HhaI, AluI, HaeIII, RsaI, HpaII, TaqI, KpnI, ThaI and BfaI enzymes showed identical RFLP patterns in all the samples that were also identical to the profiles of the 16SrIX‐B phytoplasma subgroup. Sanger sequencing of five randomly selected amplicons confirmed that they were 100% identical to each other and had >99% identity with ‘Candidatus Phytoplasma phoenicium’‐related strains as also confirmed by the clustering in phylogenetic analysis. This is the first report of 16SrIX‐B phytoplasma presence in a non‐Prunus species, D. mucronata, also highlighting its possible role as reservoir species for this phytoplasma that is severely affecting stone fruits in the Middle East regions.
Fetal health classification from cardiotocographic data using machine learning
Authors: Mehbodniya Abolfazl , Lazar Arokia Jesu Prabhu , Webber Julian , Sharma Dilip Kumar , Jayagopalan Santhosh , K Kousalya , Singh Pallavi , Rajan Regin , Pandya Sharnil , Sengan Sudhakar
Published: December 2021

Health complications during the gestation period have evolved as a global issue. These complications sometimes result in the mortality of the fetus, which is more prevalent in developing and underdeveloped countries. The genesis of machine learning (ML) algorithms in the healthcare domain have brought remarkable progress in disease diagnosis, treatment, and prognosis. This research deploys various ML algorithms to predict fetal health from the cardiotocographic (CTG) data by labelling the health state into normal, needs guarantee, and pathology. This work assesses the influence of various factors measured through CTG to predict the health state of the fetus through algorithms like support vector machine, random forest (RF), multi‐layer perceptron, and K‐nearest neighbours. In addition to this, the regression analysis and correlation analysis revealed the influence of the attributes on fetal health. The results of the algorithms show that RF performs better than its peers in terms of accuracy, precision, recall, F1‐score, and support. This work can further enhance more promising results by performing suitable feature engineering in the CTG data.
Sustainability evolution and factors based on ecological footprint: A case study of Rizhao, China
Authors: Sun Wei , Li Junli , Qu Wenxi
Published: December 2021

Ecological footprint (EF) focuses on exploring regional sustainable development, thereby making the evaluation of sustainability an important part of academic research. However, few efforts have been made into investigating EF’s influencing factors. This study explores the changes of EF and its influencing factors in Rizhao, a coastal city in China, and verifies the changes of EF through EKC. The results are as follows: (a) The rapid growth of EF is an important cause of ecological deficit. The evolution of EF shows obvious stage characteristics. (b) In terms of composition, the EF of fossil fuel‐rich land contributes greatly to the growth of EF; the EFs of cultivated land and water area also always account for a large proportion. (c) The EF is driven by the proportion of the secondary and tertiary industries, which has an inhibitory effect. Moreover, different influencing factors determine the stage change of EF. (d) EF is used to indicate the degradation of the environment. EKC shows that Rizhao City is in a negative correlation between economic development and environmental quality, confirming the change of EF. Based on the empirical results, suggestions have, hence, been made in this study to achieve sustainable development targets.
Tragedy of the facilitated commons: A multiple‐case study of failure in systematic horizontal logistics collaboration
Authors: Sternberg Henrik , Linan Isidro , Prockl Günter , Norrman Andreas
Published: December 2021

Horizontal logistics collaboration can increase environmental sustainability and reduce shipping costs. Given these benefits—and the fact that few shippers actually opt to collaborate—public sector agencies and industry associations have attempted to sponsor and support the facilitation of horizontal logistics collaboration projects over the past 20 years. The literature, however, has yet to reveal the fact that these efforts have largely failed. Here, we introduce systematic horizontal logistics collaboration and apply Ostrom's theory of the commons and agency theory to extract antecedents on why these projects failed. We present a multiple‐case study on unsuccessful horizontal logistics collaboration projects in Great Britain, Germany, Sweden, and Denmark. We address a gap in supply chain literature with regard to systematic collaboration; we also demonstrate the utility of commons theory in the supply chain domain and contribute to the literature on supply chain collaboration with facilitators. Finally, we discuss managerial implications, both for the practitioners attempting systematic horizontal logistics collaboration and for the policymakers seeking to promote it.
Older rural people's perception of connectedness through a communication application: A qualitative descriptive study
Authors: Kikuchi Mami , Kamishima Tamotsu , Abe Hiroki , Onishi Ryuta , Takashima Risa , Hirano Michiyo
Published: December 2021

Connectedness among older people is essential for healthy communities, especially among rural populations where limited social interaction and associated health effects may be cause for concern. In this qualitative descriptive study, we explored older rural people's perception of connectedness through a communication application. The study assessed 10 participants (mean age = 76.2 years) living in rural Japan who regularly participated in a senior citizens' club. From July 2019 to January 2020, the participants used a social media application developed by our research team to meet the needs of older people. Semi‐structured interviews were conducted. Six themes representing older rural people's perception of connectedness were identified: (1) thoughtful consideration for members strengthened even without them meeting face‐to‐face, (2) encouragement received from familiar members, (3) joy in sharing daily routine with neighbors, (4) courage to advance through face‐to‐face interaction, (5) willingness to continue club membership, and (6) fear of disrupting club's harmony. Participants who used the application felt compensated for the lack of social interaction opportunities in rural settings and strengthened their existing relationships.
Device‐detected nonsustained ventricular tachycardia in adult congenital heart disease without tetralogy of fallot
Authors: Doctor Pezad , Aggarwal Sanjeev , Lawrence David K. , Gupta Pooja , Singh Gautam K. , Madhavan Malini , Sriram Chenni S.
Published: December 2021

Objectives

To evaluate any association between non‐sustained ventricular tachycardia (NSVT) detected by intra‐cardiac device and clinical outcomes in repaired adult congenital heart disease (ACHD) without tetralogy of Fallot (TOF).

Background

NSVT portends a higher risk of serious ventricular tachyarrhythmia in TOF. However its clinical significance when incidentally detected by implantable cardiac device is not well elucidated in non‐TOF ACHD cohort.

Methods

We performed a single center, retrospective, longitudinal follow‐up study in repaired ACHD (≥18 years) patients without TOF who hosted a pacemaker or automatic implantable cardiac defibrillator (AICD). The cohort was divided based on presence/absence of device detected NSVT. The primary end‐point was a composite of sustained ventricular tachycardia (VT), ventricular fibrillation (VF), or sudden cardiac death (SCD).

Results

One hundred fifty eight patients (male 56.3%, median [IQR] age of 35 [28–43] years at last follow‐up] with longitudinal post‐implant follow‐up duration of 8 (5–12) years were included. NSVT was detected in 52 (33%) patients. The primary composite end‐point was more frequent in NSVT group [11.5% vs. 2.8%; p = .04]. Patients with NSVT were (i) older at the time of initial implant (age 25 vs. 18 years, p = .011) and more frequently demonstrated (ii) systemic ventricular dysfunction (44% vs. 26%; p = .015), as well as (iii) history of ventriculotomy (38% vs. 21%; p = .017).

Conclusions

In our repaired ACHD cohort, we noted a significant association between device‐detected‐NSVT and the primary composite end‐point of sustained VT/VF or SCD. Systemic ventricular dysfunction and history of ventriculotomy were more frequent in the NSVT group and likely constituted the clinical milieu.
Shoot: root ratio of seedlings is associated with species niche on soil moisture gradient
Authors: Mašková T. , Maternová J. , Těšitel J.
Published: December 2021

Surviving the seedling phase is crucial for the establishment of plant individuals and populations. In ecosystems with dynamic water availability such as temperate grasslands, seedlings should adjust their growth strategy not only to match the current conditions but also to secure resource acquisition in the future. Here, we explored evolutionary adaptations determining plant early growth strategies in herbaceous species of temperate grasslands differing in their requirements for soil water availability.

We chose 15 plant genera, within which we selected species differing in their Ellenberg indicator values for moisture. We cultivated the seedlings under standard conditions with sufficient water supply for 4 weeks. Subsequently, we measured length‐based and mass‐based shoot:root ratio to investigate seedling growth strategy and its association with species ecological niche. Seed size and content of soil‐borne nutrients were considered as potential covariates affecting this association.

Linear mixed‐effect models identified the length‐based shoot:root ratio of seedlings was positively associated with soil moisture requirements in a congeneric species comparison. Nitrogen and phosphorus seed concentrations had an additional negative effect on the shoot:root ratio. Neither of these trends was found for the mass‐based shoot:root ratio.

We demonstrated for the first time that there might be a general adaptation modifying the seedling shoot:root ratio according to the species niche position on the soil moisture gradient in temperate grassland species across a broad range of angiosperm phylogeny. This adaptation seems to be affected by seed mineral nutrient reserves and may operate in parallel to the well‐known phenotypic plasticity.
Two archetypes of business model innovation processes for manufacturing firms in the context of digital transformation
Authors: Rummel Florian , Hüsig Stefan , Steinhauser Stefanie
Published: December 2021

The digital transformation is forcing manufacturing firms to innovate beyond new products and services and to develop their digital business model innovation (BMI) processes in order to stay competitive. This study explores how the innovation processes of manufacturing firms can be designed in order to develop novel business models to address the challenges of digitalization. The study uses a multiple‐case study approach, where data on BMI processes was collected in six manufacturing firms. The results show that the design of BMI processes in the digital age differs conceptually between B2C and B2B manufacturing firms. While BMI processes in B2C firms follow a semi‐structured approach that considers experimentation, process models in B2B firms show similarities with a new product development (NPD) hybrid model comprising stage‐gate methods and agility. This new typology aims to structure the heterogeneity of BMI process models described in the literature. Finally, this study proposes two archetype process models for digital BMI for B2C and B2B firms with specific digital process characteristics that manufacturing firms could consider when designing a BMI process in the context of digital transformation without reinventing the wheel over and over again.
Sickle cell disease patients in two London trusts: Genotyping including RH variants
Authors: Hui Yee Man Tracy , Gurung Kamala , Layton David Mark , Ibidapo Mercy , Grimsley Shane , Regan Fiona
Published: December 2021

Background

All SCD patients need extended RBC antigen typing (by serology or genotyping) for provision of extended RH, K matched blood and to guide RBC selection in those with complex transfusion requirements. Genotyping can also identify RH variants which can cause sensitisation even when extended RH phenotypically matched blood is provided and alloantibodies associated with RH variants can cause HTRs.

Objectives

To review the use of RBC genotyping in SCD patients at two London trusts (ICHNT, LNWH) with a focus on RH variants.

Methods

Retrospective review with data collected from clinical notes, local and national pathology reporting systems.

Results

A 311/482 (64%) ICHNT patients and 181/346 (52%) LNWH patients had extended genotyping. Of genotyped patients, 68 (22%) ICHNT and 31 (17%) LNWH patients had RH variants. Eight ICHNT patients had RH variants and corresponding antibodies associated with RH variants; 4/8 received multiple transfusions with antigen positive RBCs but had no evidence of haemolysis. One LNWH patient had a RH variant with corresponding alloantibody but could not be investigated further for possible HTR.

Conclusions

Most patients (59%) had genotyping and a significant number had RH variants (99, 20%). A small proportion (9, 9%) had antibodies associated with RH variants, but with no evidence of clinically significant HTRs despite transfusions in four of them with antigen positive RBCs. All SCD patients should have RBC genotyping including RH variants (preferentially over extended phenotyping) to guide better selection of RBC units. However, where antigen negative blood cannot be provided, the risk of alloimmunisation is not inevitable and subsequent HTRs from antibodies associated with RH variants might not always occur.
Modified prepubic urethrostomy with body wall tunneling: Description of technique and long‐term outcome in eight male cats
Authors: Bresciani Luca , Mosca Andrea , Romussi Stefano
Published: December 2021

Objective

To describe the procedure, complications, and long‐term outcome of cats that underwent a modified prepubic urethrostomy (mPPU) technique for the management of proximal urethral obstructions.

Animals

Eight male cats.

Study Design

Short case series.

Methods

Medical records were reviewed for signalment, diagnostic investigation, details of the surgical procedure, and complications of cats that underwent mPPU.

Results

mPPU was well tolerated by all patients, and no intraoperative complications were reported. The duration of follow‐up ranged from 13 to 84 months (median 19 months). Early postoperative skin scalding around the stoma associated with mild urinary incontinence during recumbency occurred and was self‐limiting in all patients. Two cats required surgical revision at 5 and 6 months, respectively, due to a progressive weight gain and accumulation of abdominal fat around the stoma, causing a partial stomal obstruction. Resolution of clinical signs was reported in both patients.

Conclusions

mPPU was easy to perform and offered favorable outcomes in this cohort of cats.
3D-printed sound absorber considering ventilation
Authors: Wang Heng , Mao Qibo
Published: December 2021

To reduce the noise in a ventilated system, three-dimensional (3D)-printed sound absorbers, based on multiple spiral waveguides, are proposed in this letter. A waveguide unit consists of a fixed-length cylindrical straight tube and a certain number of spiral tubes. The geometrical parameters of the spiral waveguides can be flexibly regulated, aided by the 3D digital modeling method to control the phase of the sound wave. Experimental results show that the proposed sound absorber can obtain the sound transmission loss (STL) about 9.6 dB in a frequency range of 300–1250 Hz with an 18% ventilation ratio.
Imprint of chondrule formation on the K and Rb isotopic compositions of carbonaceous meteorites
Authors: Nie Nicole X. , Chen Xin-Yang , Hopp Timo , Hu Justin Y. , Zhang Zhe J. , Teng Fang-Zhen , Shahar Anat , Dauphas Nicolas
Published: December 2021

Potassium and rubidium isotopes reveal the cause for the depletion of moderately volatile elements in planetary building blocks.
Comment on “Evaluating the cardiovascular safety of sclerostin inhibition using evidence from meta-analysis of clinical trials and human genetics”
Authors: Hólm Hilma , Sulem Patrick , Tragante Vinicius , Thorsteinsdottir Unnur , Gudbjartsson Daniel F. , Stefansson Kari
Published: December 2021

Genetic data do not provide evidence for SOST inhibition causing cardiovascular disease.
Capsules and Extracellular Polysaccharides in Escherichia coli and Salmonella
Authors: Sande Caitlin , Whitfield Chris
Published: December 2021

Escherichia coli
and
Salmonella
isolates produce a range of different polysaccharide structures that play important roles in their biology.
E. coli
isolates often possess capsular polysaccharides (K antigens), which form a surface structural layer. These possess a wide range of repeat-unit structures.
Time Series Transcriptomic Analysis of Bronchoalveolar Lavage Cells from Piglets Infected with Virulent or Low-Virulent Porcine Reproductive and Respiratory Syndrome Virus 1
Authors: Sánchez-Carvajal J. M. , Rodríguez-Gómez I. M. , Ruedas-Torres I. , Zaldívar-López S. , Larenas-Muñoz F. , Bautista-Moreno R. , Garrido J. J. , Pallarés F. J. , Carrasco L. , Gómez-Laguna J.
Published: December 2021

Porcine reproductive and respiratory syndrome virus (PRRSV) is one of the major threats to swine health and global production, causing substantial economic losses. We explore the mechanisms involved in the modulation of host immune response at lung level performing a time-series transcriptomic analysis upon experimental infection with two PRRSV-1 strains of different virulence.
Muribaculaceae
Genomes Assembled from Metagenomes Suggest Genetic Drivers of Differential Response to Acarbose Treatment in Mice
Authors: Smith Byron J. , Miller Richard A. , Schmidt Thomas M.
Published: December 2021

The drug acarbose is used to treat diabetes by preventing the breakdown of starch in the small intestine, resulting in dramatic changes in the abundance of some members of the gut microbiome and its fermentation products. In mice, several of the bacteria that respond most positively are classified in the family
Muribaculaceae
, members of which produce propionate as a primary fermentation product.
Pseudomonas aeruginosa Mobbing-Like Behavior against Acanthamoeba castellanii Bacterivore and Its Rapid Control by Quorum Sensing and Environmental Cues
Authors: Shteindel Nimrod , Gerchman Yoram
Published: December 2021

Pseudomonas aeruginosa
was shown previously to attack amoebae and other predators by adhering to them and injecting them with virulent substances. In this work, we show that an active, coordinated group behavior is enacted by the bacteria to utilize these molecular components, responding to both predator and bacterial population density.
A Conserved Histophilus somni 23S Intervening Sequence Yields Functional, Fragmented 23S rRNA
Authors: Harhay Gregory P. , Harhay Dayna M. , Brader Kerry D. , Smith Timothy P. L.
Published: December 2021

The genome biology underlying
H. somni
virulence, pathogenicity, environmental adaptability, and broad tissue tropism is understood poorly. We identified a novel
H. somni
109-nt IVS stem-loop structure, of which the central portion is excised from the 23S rRNA transcript, resulting in the fragmentation of this rRNA in the
H. somni
isolate USDA-ARS-USMARC-63250 and the release of a 94-nt structured RNA of unknown function.
Involvement of ClpE ATPase in Physiology of Streptococcus mutans
Authors: Biswas Saswati , Dhaked Hemendra Pal Singh , Keightley Andrew , Biswas Indranil
Published: December 2021

When bacteria encounter environmental stresses, the expression of various proteins collectively known as heat shock proteins is induced. These heat shock proteins are necessary for cell survival specifically under conditions that induce protein denaturation.
Why are children with asthma bullied? A risk factor analysis
Authors: Charles Rebecca , Brand Paul L P , Gilchrist Francis J , Wildhaber Johannes , Carroll Will
Published: December 2021

The links between bullying and asthma have not been explored in children. We wanted to determine the child/parent factors and attitudes associated with asthma-related bullying. Individual child/parent responses of children with asthma (N=943) from the Room to Breathe survey were analysed. 1 in 10 children reported asthma-related bullying/teasing (n=93). Children with well-controlled asthma were less likely to report being a victim of asthma-related bullying/teasing (OR 0.51, 95% CI 0.23 to 0.84, p=0.006). Being a victim of bullying/teasing was more common in children reporting activity restriction (OR 1.74, 95% CI 1.11 to 2.75, p=0.010), who described their asthma as ‘bad’ (OR 3.02, 95% CI 1.86 to 4.85, p<0.001) and those whose parents reported ongoing asthma-related health worries (OR 1.64, 95% CI 1.04 to 2.58, p=0.024). Asthma consultations should incorporate specific questions about bullying and be child-focused in order to gain a representative appreciation of asthma control and its impact on the child’s life.
Informed consent and assent guide for paediatric clinical trials in Europe
Authors: Lepola Pirkko , Kindred Maxine , Giannuzzi Viviana , Glosli Heidi , Dehlinger-Kremer Martine , Dalrymple Harris , Neubauer David , Boylan Geraldine B , Conway Jean , Dewhurst Jo , Hoffman Diane
Published: December 2021

Objective

Clinical trial sponsors spend considerable resources preparing informed consent (IC) and assent documentation for multinational paediatric clinical trial applications in Europe due to the limited and dispersed patient populations, the variation of national legal and ethical requirements, and the lack of detailed guidance. The aim of this study was to design new easy-to-use guide publicly available on European Medicines Agency’s, Enpr-EMA website for all stakeholders.

Methods

Current EU legal, ethical and regulatory guidance for paediatric clinical trials were collated, analysed and divided into 30 subject elements in two tables. The European Network of Young Person’s Advisory Group reviewed the data and provided specific comments. A three-level recommendation using ‘traffic light’ symbols was designed for four age groups of children, according to relevance and the requirements.

Results

A single guide document includes two tables: (1) general information and (2) trial-specific information. In the age group of 6–9 years old, 92% of the trial-specific subject elements can be or should be included in the IC discussion. Even in the youngest possible age group (2–5 years old children), the number of elements considered was, on average, 52%.

Conclusion

The EU Clinical Trial Regulation (2014) does not contain specific requirements exclusively for paediatric clinical trials. This work is the first to extensively collate all the current legal, regulatory and ethical documentation on the IC process, together with input from adolescents. This guide may increase the ethical standards in paediatric clinical trials.
Handheld chromatic pupillometry can accurately and rapidly reveal functional loss in glaucoma
Authors: Najjar Raymond P , Rukmini A V , Finkelstein Maxwell T , Nusinovici Simon , Mani Baskaran , Nongpiur Monisha Esther , Perera Shamira , Husain Rahat , Aung Tin , Milea Dan
Published: December 2021

Background/aims

Early detection and treatment of glaucoma can delay vision loss. In this study, we evaluate the performance of handheld chromatic pupillometry (HCP) for the objective and rapid detection of functional loss in glaucoma.

Methods

In this clinic-based, prospective study, we enrolled 149 patients (median (IQR) years: 68.5 (13.6) years) with confirmed glaucoma and 173 healthy controls (55.2 (26.7) years). Changes in pupil size in response to 9 s of exponentially increasing blue (469 nm) and red (640 nm) light-stimuli were assessed monocularly using a custom-built handheld pupillometer. Pupillometric features were extracted from individual traces and compared between groups. Features with the highest classification potential, selected using a gradient boosting machine technique, were incorporated into a generalised linear model for glaucoma classification. Receiver operating characteristic curve analyses (ROC) were used to compare the performance of HCP, optical coherence tomography (OCT) and Humphrey Visual Field (HVF).

Results

Pupillary light responses were altered in glaucoma compared with controls. For glaucoma classification, HCP yielded an area under the ROC curve (AUC) of 0.94 (95% CI 0.91 to 0.96), a sensitivity of 87.9% and specificity of 88.4%. The classification performance of HCP in early-moderate glaucoma (visual field mean deviation (VFMD) > -12 dB; AUC=0.91 (95% CI 0.87 to 0.95)) was similar to HVF (AUC=0.91) and reduced compared with OCT (AUC=0.97; p=0.01). For severe glaucoma (VFMD ≤ -12 dB), HCP had an excellent classification performance (AUC=0.98, 95% CI 0.97 to 1) that was similar to HVF and OCT.

Conclusion

HCP allows for an accurate, objective and rapid detection of functional loss in glaucomatous eyes of different severities.
Bystander interventions and survival after exercise-related sudden cardiac arrest: a systematic review
Authors: Grubic Nicholas , Hill Braeden , Phelan Dermot , Baggish Aaron , Dorian Paul , Johri Amer M
Published: December 2021

Objective

To evaluate the provision of bystander interventions and rates of survival after exercise-related sudden cardiac arrest (SCA).

Design

Systematic review.

Data sources

MEDLINE, EMBASE, PubMed, CINAHL, SPORTDiscus, Cochrane Library and grey literature sources were searched from inception to November/December 2020.

Study eligibility criteria

Observational studies assessing a population of exercise-related SCA (out-of-hospital cardiac arrests that occurred during exercise or within 1 hour of cessation of activity), where bystander cardiopulmonary resuscitation (CPR) and/or automated external defibrillator (AED) use were reported, and survival outcomes were ascertained.

Methods

Among all included studies, the median (IQR) proportions of bystander CPR and bystander AED use, as well as median (IQR) rate of survival to hospital discharge, were calculated.

Results

A total of 29 studies were included in this review, with a median study duration of 78.7 months and a median sample size of 91. Most exercise-related SCA patients were male (median: 92%, IQR: 86%–96%), middle-aged (median: 51, IQR: 39–56 years), and presented with a shockable arrest rhythm (median: 78%, IQR: 62%–86%). Bystander CPR was initiated in a median of 71% (IQR: 59%–87%) of arrests, whereas bystander AED use occurred in a median of 31% (IQR: 19%–42%) of arrests. Among the 19 studies that reported survival to hospital discharge, the median rate of survival was 32% (IQR: 24%–49%). Studies which evaluated the relationship between bystander interventions and survival outcomes reported that both bystander CPR and AED use were associated with survival after exercise-related SCA.

Conclusion

Exercise-related SCA occurs predominantly in males and presents with a shockable ventricular arrhythmia in most cases, emphasising the importance of rapid access to defibrillation. Further efforts are needed to promote early recognition and a rapid bystander response to exercise-related SCA.
Mental health trajectories in undergraduate students over the first year of university: a longitudinal cohort study
Authors: Adams Kiera Louise , Saunders Kate E , Keown-Stoneman Charles Donald George , Duffy Anne C
Published: December 2021

Objective

This study examined the association between candidate psychosocial and lifestyle variables and the trajectories of clinically significant anxiety and depressive symptoms from entry to completion of first-year university.

Design

A longitudinal cohort study

Participants

First-year undergraduate students

Methods

We analysed the responses of 1686 first-year undergraduate students attending Queen’s University who completed electronic surveys at both the beginning and completion of their academic year. Predictors of change in positive anxiety and depressive symptom screens (based on exceeding validated symptom threshold scores) were identified using logistic regression.

Results

Increased university connectedness reduced the odds of emergent significant depressive and anxiety symptoms in healthy students and increased the odds of recovery in students who screened positive at the start of university. Students who screened positive for depression or anxiety at university entry were less likely to recover if they had a lifetime history of internalising disorders. Healthy students who increased their drug use over their first year had higher odds of developing significant levels of both anxiety and depressive symptoms by completion of the academic year.

Conclusions

Moderate to severe levels of anxiety and depressive symptoms are common among students at entry to university and persist over the first year. University connectedness may mitigate the risk of persistent or emergent symptoms, whereas drug use appears to increase these risks. Findings have implications for university well-being initiatives.
Common elements of service delivery models that optimise quality of life and health service use among older people with advanced progressive conditions: a tertiary systematic review
Authors: Bayly Joanne , Bone Anna E , Ellis-Smith Clare , Tunnard India , Yaqub Shuja , Yi Deokhee , Nkhoma Kennedy B , Cook Amelia , Combes Sarah , Bajwah Sabrina , Harding Richard , Nicholson Caroline , Normand Charles , Ahuja Shalini , Turrillas Pamela , Kizawa Yoshiyuki , Morita Tatsuya , Nishiyama Nanako , Tsuneto Satoru , Ong Paul , Higginson Irene J , Evans Catherine J , Maddocks Matthew
Published: December 2021

Introduction

Health and social care services worldwide need to support ageing populations to live well with advanced progressive conditions while adapting to functional decline and finitude. We aimed to identify and map common elements of effective geriatric and palliative care services and consider their scalability and generalisability to high, middle and low-income countries.

Methods

Tertiary systematic review (Cochrane Database of Systematic Reviews, CINAHL, Embase, January 2000–October 2019) of studies in geriatric or palliative care that demonstrated improved quality of life and/or health service use outcomes among older people with advanced progressive conditions. Using frameworks for health system analysis, service elements were identified. We used a staged, iterative process to develop a ‘common components’ logic model and consulted experts in geriatric or palliative care from high, middle and low-income countries on its scalability.

Results

78 studies (59 geriatric and 19 palliative) spanning all WHO regions were included. Data were available from 17 739 participants. Nearly half the studies recruited patients with heart failure (n=36) and one-third recruited patients with mixed diagnoses (n=26). Common service elements (≥80% of studies) included collaborative working, ongoing assessment, active patient participation, patient/family education and patient self-management. Effective services incorporated patient engagement, patient goal-driven care and the centrality of patient needs. Stakeholders (n=20) emphasised that wider implementation of such services would require access to skilled, multidisciplinary teams with sufficient resource to meet patients’ needs. Identified barriers to scalability included the political and societal will to invest in and prioritise palliative and geriatric care for older people, alongside geographical and socioeconomic factors.

Conclusion

Our logic model combines elements of effective services to achieve optimal quality of life and health service use among older people with advanced progressive conditions. The model transcends current best practice in geriatric and palliative care and applies across the care continuum, from prevention of functional decline to end-of-life care.

PROSPERO registration number

CRD42020150252.
Disparities by sex in P2Y12inhibitor therapy duration, or differences in the balance of ischaemic-benefit and bleeding-risk clinical outcomes in older women versus comparable men following acute myocardial infarction? A P2Y12inhibitor new user retrospective cohort analysis of US Medicare claims data
Authors: Hickson Ryan P , Kucharska-Newton Anna M , Rodgers Jo E , Sleath Betsy L , Fang Gang
Published: December 2021

Objectives

To determine if comparable older women and men received different durations of P2Y12inhibitor therapy following acute myocardial infarction (AMI) and if therapy duration differences were justified by differences in ischaemic benefits and/or bleeding risks.

Design

Retrospective cohort.

Setting

20% sample of 2007–2015 US Medicare fee-for-service administrative claims data.

Participants

≥66-year-old P2Y12inhibitor new users following 2008–2013 AMI hospitalisation (N=30 613). Older women compared to older men with similar predicted risks of study outcomes.

Primary and secondary outcome measures

Primary outcome: P2Y12inhibitor duration (modelled as risk of therapy discontinuation). Secondary outcomes: clinical events while on P2Y12inhibitor therapy, including (1) death/hospice admission, (2) composite of ischaemic events (AMI/stroke/revascularisation) and (3) hospitalised bleeds. Cause-specific risks and relative risks (RRs) estimated using Aalen-Johansen cumulative incidence curves and bootstrapped 95% CIs.

Results

10 486 women matched to 10 486 men with comparable predicted risks of all 4 study outcomes. No difference in treatment discontinuation was observed at 12 months (women 31.2% risk; men 30.9% risk; RR 1.01; 95% CI 0.97 to 1.05), but women were more likely than men to discontinue therapy at 24 months (54.4% and 52.9% risk, respectively; RR 1.03; 95% CI 1.00 to 1.05). Among patients who did not discontinue P2Y12inhibitor therapy, women had lower 24-month risks of ischaemic outcomes than men (13.1% and 14.7%, respectively; RR 0.90; 95% CI 0.84 to 0.96), potentially lower 24-month risks of death/hospice admission (5.0% and 5.5%, respectively; RR 0.91; 95% CI 0.82 to 1.02), but women and men both had 2.5% 24-month bleeding risks (RR 0.98; 95% CI 0.82 to 1.14).

Conclusions

Risks for death/hospice and ischaemic events were lower among women still taking a P2Y12inhibitor than comparable men, with no difference in bleeding risks. Shorter P2Y12inhibitor durations in older women than comparable men observed between 12 and 24 months post-AMI may reflect a disparity that is not justified by differences in clinical need.
Technology-based interventions for nursing home residents: a systematic review protocol
Authors: Su Zhaohui , Meyer Kylie , Li Yue , McDonnell Dean , Joseph Nitha Mathew , Li Xiaoshan , Du Yan , Advani Shailesh , Cheshmehzangi Ali , Ahmad Junaid , da Veiga Claudimar Pereira , Chung Roger Yat-Nork , Wang Jing , Hao Xiaoning
Published: December 2021

Introduction

A growing number of technology-based interventions are used to support the health and quality of life of nursing home residents. The onset of COVID-19 and recommended social distancing policies that followed led to an increased interest in technology-based solutions to provide healthcare and promote health. Yet, there are no comprehensive resources on technology-based healthcare solutions that describe their efficacy for nursing home residents. This systematic review will identify technology-based interventions designed for nursing home residents and describe the characteristics and effects of these interventions concerning the distinctive traits of nursing home residents and nursing facilities. Additionally, this paper will present practical insights into the varying intervention approaches that can assist in the delivery of broad digital health solutions for nursing home residents amid and beyond the impact of COVID-19.

Methods and analysis

Databases including the PubMed, PsycINFO, CINAHL and Scopus will be used to identify articles related to technology-based interventions for nursing home residents published between 1 January 2010 to 30 September 2021. Titles, abstracts and full-text papers will be reviewed against the eligibility criteria. The Cochrane Collaboration evaluation framework will be adopted to examine the risk of bias of the included study. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures will be followed for the reporting process and implications for existing interventions and research evaluated by a multidisciplinary research team.

Ethics and dissemination

As the study is a protocol for a systematic review, ethical approval is not required. The study findings will be disseminated via peer-reviewed publications and conference presentations.

Trial registration number

CRD 42020191880.
Corpus callosum in schizophrenia with deficit and non-deficit syndrome: a statistical shape analysis
Authors: Türk Yaşar , Ercan Ilker , Sahin Ibrahim , Erdemli Gursel Basak , Uzunoglu Arda , Öge Cem , Beyazyüz Elmas , Albayrak Yakup
Published: December 2021

Background

The corpus callosum (CC) is the most targeted region in the cerebrum that integrates cognitive data between homologous areas in the right and left hemispheres.

Aims

Our study used statistical analysis to determine whether there was a correlation between shape changes in the CC in patients with schizophrenia (SZ) (deficit syndrome (DS) and non-deficit syndrome (NDS)) and healthy control (HC) subjects.

Methods

This study consisted of 27 HC subjects and 50 schizophrenic patients (20 with DS and 30 with NDS). 3 patients with DS and 4 patients with NDS were excluded. Three-dimensional, sagittal, T1-spoiled, gradient-echo imaging was used. Standard anatomical landmarks were selected and marked on each image using specific software.

Results

As to comparing the Procrustes mean shapes of the CC, statistically significant differences were observed between HC and SZ (DS+NDS) (p=0.017, James’s Fj=73.732), HC and DS (p<0.001, James’s Fj=140.843), HC and NDS (p=0.006, James’s Fj=89.178) and also DS and NDS (p<0.001, James’s Fj=152.967). Shape variability in the form of CC was 0.131, 0.085, 0.082 and 0.086 in the HC, SZ (DS+NDS), DS and NDS groups, respectively.

Conclusions

This study reveals callosal shape variations in patients with SZ and their DS and NDS subgroups that take into account the CC’s topographic distribution.
Fermionic singlet dark matter in one-loop solutions to the $$R_K$$ anomaly: a systematic study
Authors: Becker Mathias , Döring Dominik , Karmakar Siddhartha , Päs Heinrich
Published: December 2021

We study the dark matter phenomenology of Standard Model extensions addressing the reported anomaly in the $$R_K$$

R
K

observable at one-loop. The article covers the case of fermionic singlet DM coupling leptophilically, quarkphilically or amphiphilically to the SM. The setup utilizes a large coupling of the new particle content to the second lepton generation to explain the $$R_K$$

R
K

anomaly, which in return tends to diminish the dark matter relic density. Further, dark matter direct detection experiments provide stringent bounds even in cases where the dark matter candidate only contributes a small fraction of the observed dark matter energy density. In fact, direct detection rules out all considered models as an explanation for the $$R_K$$

R
K

anomaly in the case of Dirac dark matter. Conversely, for Majorana dark matter, the $$R_K$$

R
K

anomaly can be addressed in agreement with direct detection in coannihilation scenarios. For leptophilic dark matter this region only exists for $$M_\text {DM} \lesssim 1000 \, \mathrm {GeV}$$

M
DM

≲
1000

GeV

and dark matter is underabundant. Quarkphilic and amphiphilic scenarios even provide narrow regions of parameter space where the observed relic density can be reproduced while offering an explanation to $$R_K$$

R
K

in agreement with direct detection experiments.
A measurement of the mean electronic excitation energy of liquid xenon
Authors: Baudis Laura , Sanchez-Lucas Patricia , Thieme Kevin
Published: December 2021

Detectors using liquid xenon as target are widely deployed in rare event searches. Conclusions on the interacting particle rely on a precise reconstruction of the deposited energy which requires calibrations of the energy scale of the detector by means of radioactive sources. However, a microscopic calibration, i.e. the translation from the number of excitation quanta into deposited energy, also necessitates good knowledge of the energy required to produce single scintillation photons or ionisation electrons in liquid xenon. The sum of these excitation quanta is directly proportional to the deposited energy in the target. The proportionality constant is the mean excitation energy and is commonly known as W-value. Here we present a measurement of the W-value with electronic recoil interactions in a small dual-phase xenon time projection chamber with a hybrid (photomultiplier tube and silicon photomultipliers) photosensor configuration. Our result is based on calibrations at $$\mathcal {O}(1{-}10\,{\hbox {keV}})$$

O
(
1
-
10

keV
)

with internal $${^{37}\hbox {Ar}}$$

37

Ar

and $${^{83\text {m}}\hbox {Kr}}$$

83
m

Kr

sources and single electron events. We obtain a value of $$W={11.5}{} \, ^{+0.2}_{-0.3} \, \mathrm {(syst.)} \, \hbox {eV}$$

W
=

11.5

-
0.3

+
0.2

(
syst
.
)

eV

, with negligible statistical uncertainty, which is lower than previously measured at these energies. If further confirmed, our result will be relevant for modelling the absolute response of liquid xenon detectors to particle interactions.
Enlightening the CSL model landscape in inflation
Authors: León Gabriel , Bengochea Gabriel R.
Published: December 2021

We propose a novel realization for the natural extrapolation of the continuous spontaneous localization (CSL) model, in order to account for the origin of primordial inhomogeneities during inflation. This particular model is based on three main elements: (i) the semiclassical gravity framework, (ii) a collapse-generating operator associated to a relativistic invariant scalar of the energy-momentum tensor, and (iii) an extension of the CSL parameter(s) as a function of the spacetime curvature. Furthermore, employing standard cosmological perturbation theory at linear order, and for a reasonable range within the parameter space of the model, we obtain a nearly scale invariant power spectrum consistent with recent observational CMB data. This opens a vast landscape of different options for the application of the CSL model to the cosmological context, and possibly sheds light on searches for a full covariant version of the CSL theory.