bluuebunny/crossref_metadata_2025 huggingface dataset:
Visual attention toward emotional stimuli: Anxiety symptoms correspond to distinct gaze patterns
Authors: Rutter Lauren A. , Norton Daniel J. , Brown Timothy A.
Published: May 2021

Decades of research have established a link between emotional disorders and attentional biases for emotional stimuli, but the relationship between symptom severity and visual attention is still not fully understood. Depression has been associated with increased attention towards dysphoric stimuli and decreased attention on positive stimuli (“negativity bias”), and some studies have also shown this trend in anxiety disorders. We examined eye fixation variables in 47 participants with emotional disorders completing an emotion recognition task. Results showed that depression severity was not associated with increased fixations on dysphoric stimuli, however, higher levels of generalized anxiety predicted increased fixations in the mouth region of sad and happy faces. Higher levels of social interaction anxiety predicted reduced fixations in the eye region of happy faces. While we did not replicate the negativity bias that has been shown in prior studies, our sample was highly comorbid, indicating the need to consider comorbidity, disorder severity, and the task itself when conducting research on visual attention in clinical samples. Additionally, more attention should be paid to the mouth region of emotional faces, as it may provide more specific information regarding the visual processing of emotions.
Risk perception of the pre-distribution of stable iodine to guardians of children living around the Genkai Nuclear Power Plant, Saga Prefecture, Japan
Authors: Matsunaga Hitomi , Orita Makiko , Taira Yasuyuki , Takamura Noboru
Published: May 2021

Iodine thyroid blocking (ITB) is effective for preventing childhood thyroid cancer when radioactive iodine is released into the environment during a nuclear power plant accident. Japan employs the pre-distribution of stable iodine (PDSI) to residents living near nuclear power plants; however, the number of residents who have actually received stable iodine to date remains limited. The aim of this study was to evaluate the profile of guardians of children living around the Genkai Nuclear Power Plant (GNPP) in Japan. We distributed self-administered questionnaires regarding perception of risks associated with administration of stable iodide to approximated 400 guardians of children aged 0–6 in 10 kindergartens located in four municipalities. We obtained responses from 286 guardians, and after excluding invalid responses, 247 were included in the analysis. Logistic regression analysis revealed that living within 5 km of the GNPP (odds ratio [OR] = 4.48, 95% confidence interval [CI]: 2.43–8.24), awareness of preferential implementation of ITB to children (OR = 3.33, 95%CI: 1.78–6.22), and awareness of the prophylaxis booklet published by the local government (OR = 2.53, 95%CI: 1.37–4.68) were independently associated with PDSI for children. The main reasons for not receiving PDSI were “anxiety about the side effects of stable iodine” (40.2%), “distrust of the effectiveness of SI” (23.5%), “complicated procedures for receiving stable iodine” (15.7%) and “missed the date for receiving stable iodine” (8.8%). In the case of ITB implementation during a nuclear emergency, it is necessary to clarify the risk perceptions of guardians and adapt risk communication accordingly.
Effects of decision-making on indoor bouldering performances: A multi-experimental study approach
Authors: Medernach Jerry Prosper , Memmert Daniel
Published: May 2021

The purpose of this study was to investigate whether novice, intermediate, and advanced bouldering athletes would differ in their decision-making abilities and to what extent distinct problem-solving tactics would affect the athletes’ bouldering performances. Seventy-seven male bouldering athletes participated in a multi-experimental study with the conceptual replication of three bouldering tasks. Participants were allocated according to their ability levels to the novice group (NOV with n = 18), the intermediate group (INT with n = 18), or the advanced group (ADV with n = 41). The data collected for movement analysis via video consisted of the pre-ascent decision-making times, the number of movement deviations from the best solution, the number of movement mistakes, the average gripping times, the bouldering times to the top, the number of successful ascents, and the number of attempts to complete the tasks. Results among all three experiments revealed shorter decision-making times, fewer movement mistakes, and shorter average gripping and bouldering times to the top in the ADV group than in the NOV group and the INT group. Furthermore, participants from the ADV group demonstrated fewer movement deviations than participants from the NOV group (in all three experiments) and the INT group (Experiment 1 and Experiment 2). Moreover, participants from the ADV group and the INT group were characterized, in all three experiments, by a higher number of successful ascents and a lower number of attempts to complete the tasks than participants from the NOV group. In total, these findings emphasize that accomplished decision-making abilities consist of a key determinant in successful indoor bouldering performances.
Evaluation of the test accuracy of a SARS-CoV-2 rapid antigen test in symptomatic community dwelling individuals in the Netherlands
Authors: Van der Moeren Nathalie , Zwart Vivian F. , Lodder Esther B. , Van den Bijllaardt Wouter , Van Esch Harald R. J. M. , Stohr Joep J. J. M. , Pot Joost , Welschen Ineke , Van Mechelen Petra M. F. , Pas Suzan D. , Kluytmans Jan A. J. W.
Published: May 2021

Background

SARS-CoV-2 real-time reverse transcriptase polymerase chain reaction (qRT-PCR) is well suited for the diagnosis of clinically ill patients requiring treatment. Application for community testing of symptomatic individuals for disease control purposes however raises challenges. SARS-CoV-2 rapid antigen tests might offer an alternative, but quality evidence on their performance is limited.

Methods

We conducted an evaluation of the test accuracy of the ‘BD Veritor System for Rapid Detection of SARS-CoV-2’ (VRD) compared to qRT-PCR on combined nose/throat swabs obtained from symptomatic individuals at Municipal Health Service (MHS) COVID-19 test centers in the Netherlands. In part one of the study, with the primary objective to evaluate test sensitivity and specificity, all adults presenting at one MHS test center were eligible for inclusion. In part two, with the objective to evaluate test sensitivity stratified by Ct (cycle threshold)-value and time since symptom onset, adults who had a positive qRT-PCR obtained at a MHS test center were eligible.

Findings

In part one (n = 352) SARS-CoV-2 prevalence was 4.8%, overall specificity 100% (95%CI: 98·9%-100%) and sensitivity 94·1% (95%CI: 71·1%-100%). In part two (n = 123) the sensitivity was 78·9% (95%CI: 70·6%-85·7%) overall, 89·4% (95% CI: 79·4%-95·6%) for specimen obtained within seven days after symptom onset and 93% (95% CI: 86%-97.1%) for specimen with a Ct-value below 30.

Interpretation

The VRD is a promising diagnostic for COVID-19 testing of symptomatic community-dwelling individuals within seven days after symptom onset in context of disease control. Further research on practical applicability and the optimal position within the testing landscape is needed.
Self-reported history of intensity of smoking is associated with risk factors for suicide among high school students
Authors: Dasagi Meenakshi , Mantey Dale S. , Harrell Melissa B. , Wilkinson Anna V.
Published: May 2021

Objective

To examine the relationship between current cigarette smoking patterns and three established risk factors for suicide using nationally representative data of high school students in the United States.

Methods

We analyzed cross-sectional data from the national Youth Risk Behavior Surveillance Survey (YRBSS)–United States, 2017. Multivariable, logistic regressions examined the association between 3 cigarette smoking behaviors [i.e., past 30-day cigarette (n = 13,731), frequent (n = 1,093) and heavy (n = 880) smoking] and 3 risk factors for suicidal outcomes [feeling sad or hopeless, suicidal ideation, suicide plan] assessed over the previous year.

Results

Among high school cigarette smokers, smoking 11 or more cigarettes per day (i.e., heavy smoking) was associated with 3.43 (95% CI: 1.69, 6.94) greater odds of reporting feeling sad or hopeless, 2.97 (95% CI: 1.60, 5.51) greater odds of reporting suicidal ideations, and 2.11 (95% CI: 1.34, 3.32) greater odds of reporting having ever planned a suicide attempt, controlling for covariates.

Conclusions

Our study shows that it is not simply cigarette smoking, but heavy cigarette smoking that is a risk factor for suicidal outcomes among adolescents.

Public health implications

A comprehensive plan is needed to accommodate heavy adolescent smokers who are at increased suicidal risk.
The implementation and role of a staff naloxone program for non-profit community-based sites in British Columbia: A descriptive study
Authors: Williams Sierra , King Tanis , Papamihali Kristi , Buxton Jane A.
Published: May 2021

Introduction

The BC Centre for Disease Control implemented the Facility Overdose Response Box (FORB) program December 1st, 2016 to train and support non-healthcare service providers who may respond to an overdose in the workplace. The program aims to support staff at non-profit community-based organizations by ensuring policy development, training, practice overdose response exercises, and post-overdose debriefing opportunities are established and implemented.

Materials and methods

Three data sources were used in this descriptive cross-sectional study: FORB site registration data; naloxone administration forms; and a survey that was distributed to FORB sites in February 2019. FORB program site and naloxone administration data from December 1st, 2016 to December 31st, 2019 were analyzed using descriptive statistics. A Cochran-Armitage test was used to assess trends over time in naloxone administration event characteristics. Site coordinator survey results are reported to supplement findings from administrative data.

Results

As of December 31st, 2019, FORB was implemented at 613 sites across BC and 1,758 naloxone administration events were reported. The majority (86.3%, n = 1,517) were indicated as overdose reversals. At registration, 43.6% of sites provided housing services, 26.3% offered harm reduction supplies, and 18.6% provided Take Home Naloxone. Refusal to be transported to hospital following overdose events when emergency services were called showed an increasing trend over time. Most respondents (81.3%) reported feeling confident in their ability to respond to the overdose and 59.6% were offered staff debrief. Based on the 89 site survey responses, supports most commonly made available following an overdose were debrief with a fellow staff member (91.0%), debrief with a supervisor (89.9%), and/or counselling services (84.3%).

Conclusions

The uptake of the FORB program has contributed to hundreds of overdose reversals in community settings in BC. Findings suggest that the FORB program supports developing staff preparedness and confidence in overdose response in community-based settings.
Melanocytes determine angiogenesis gene expression across human tissues
Authors: Freilikhman Shirly , Halasi Marianna , Eran Alal , Adini Irit
Published: May 2021

Several angiogenesis-dependent diseases, including age-related macular degeneration and infantile hemangioma, display differential prevalence among Black, as compared to White individuals. Although socioeconomic status and genetic architecture have been suggested as explaining these differences, we have recently shown that pigment productionper semight be involved. For example, we have shown that the extracellular protein fibromodulin is a pro-angiogenic factor highly secreted by melanocytes in White but not Black individuals. Still, additional pigment-dependent angiogenic factors and their molecular mechanisms remain to be identified. Understanding the contribution of pigmentation to angiogenesis in health and disease is essential for precision medicine of angiogenesis-dependent diseases with racial disparity. Toward that goal, we compared the transcriptomes of Black and White individuals in three tissues with angiogenic activity, namely artery, whole blood, and skin. We identified several differentially expressed angiogenesis pathways, including artery morphogenesis, regulation of endothelial cell chemotaxis, and cellular response to vascular endothelial growth factor stimulus. We then demonstrated that the expression of key genes in these pathways is directly modulated by the degree of pigmentation. We further identified the precise pigment production pathway controlling the expression of these genes, namely melanocortin 1 receptor (MC1R) signaling. These results demonstrate pigment-mediated regulation of angiogenesis-related pathways and their driver genes across human tissues.
Tracking conflict and emotions with a computational qualitative discourse analytic support approach
Authors: Rybak Nikodem , Angus Daniel J.
Published: May 2021

Accurate inferences of the emotional state of conversation participants can be critical in shaping analysis and interpretation of conversational exchanges. In qualitative analyses of discourse, most labelling of the perceived emotional state of conversation participants is performed by hand, and is limited to selected moments where an analyst may believe that emotional information is valuable for interpretation. This reliance on manual labelling processes can have implications for repeatability and objectivity, both in terms of accuracy, but also in terms of changes in emotional state that might go unnoticed. In this paper we introduce a qualitative discourse analytic support method intended to support the labelling of emotional state of conversational participants over time. We demonstrate the utility of the technique using a suite of well-studied broadcast interviews, taking a particular focus on identifying instances of inter-speaker conflict. Our findings indicate that this two-step machine learning approach can help decode how moments of conflict arise, sustain, and are resolved through the mapping of emotion over time. We show how such a method can provide useful evidence of the change in emotional state by interlocutors which could be useful to prompt and support further in-depth study.
Modeling non-Gaussian data analysis on determinants of underweight among under five children in rural Ethiopia: Ethiopian demographic and health survey 2016 evidences
Authors: Bekele Sara Abera , Fetene Moges Zerihun
Published: May 2021

Background

Childhood under-nutrition is a major global health problem. Although the rate of under-nutrition in Ethiopia has declined in the last decade, but it still remains being the major causes of morbidity and mortality of children under-five years. The problem is even worse in rural areas. The prevalence of underweight among rural children was 25% compared with 13% among urban children. To alleviate this problem, it is necessary to determine the magnitude and determinants of underweight. The study models non-Gaussian data analysis to identify risk factors associated with underweight among under-five children in rural Ethiopia.

Methodology

The data source for this study was secondary data, which was retrieved from EDHS 2016 database. It was analyzed using two model families; one with marginal models (GEE and ALR) in which responses are modeled and marginalized overall other responses, and the other is random effects model (GLMM) which is useful when the interest of the analyst lies in the individual’s response profiles as well as to evaluate within and between regional variations of underweight.

Result

From fitting non-Gaussian data analysis to identify risk factors associated with underweight among under five children in rural Ethiopia, the independent variable which have significant effect on underweight were:—Age of child, birth interval, mothers education, fathers education, wealth index, diarrhea in last two weeks, fever in last two weeks are significant and also father’s work status shows that difference in significance among the category.

Conclusion

Child age, preceding birth interval, mother’s education, household’s wealth index, fever, diarrhea, father’s education and father’s work status were associated with child underweight. Furthermore, there is both within and between regional heterogeneity of underweight among children in rural Ethiopia. Therefore, rigorous community-based interventions (such as uplifting mother’s education by providing formal education and preventing infectious diseases that cause diarrhea and fever) should be developed and executed throughout the country to improve this grave situation of underweight prevalence in rural areas of Ethiopia.
Risk factors and protective factors of depression in older people 65+. A systematic review
Authors: Maier Alexander , Riedel-Heller Steffi G. , Pabst Alexander , Luppa Melanie
Published: May 2021

Objectives

Identifying risk factors of depression can provide a better understanding of the disorder in older people. However, to minimize bias due to the influence of confounders and to detect reverse influence, a focus on longitudinal studies using multivariate analysis is required.

Design

A systematic literature search was conducted by searching the databases MEDLINE, Cochrane, PsycINFO and Web of Science for all relevant articles published from January 2000 to the end of March 2020. The following inclusion criteria were used: prospective design, nationally or regionally representative sample, published in English or German, analyzed risk factors for depression of individuals 65+ identified by multivariate analysis, and provided validity of diagnostic instrument. All results of multivariate analysis were reported and summarized.

Results

Thirty articles were identified. Heterogeneous results were found for education, female gender, self-rated health, cognitive impairment and older age, although significant in several studies. Findings hinted at a protective quality of physical activity. In terms of physical health, chronic disease and difficulty initiating sleep homogeneously increased risk of depression. Mobility impairment resulted as a risk factor in three studies. IADL impairment and vision impairment were mostly identified as significant risk factors. Alcohol consumption and smoking behavior yielded heterogenous results. Psychosocial factors were assessed similarly in multiple studies and yielded heterogenous results.

Limitations

Research was limited to articles published in English or German. Length of follow up was not considered for the presentation of results. Adjustments for and inclusion of different variables in the studies may distort results.

Conclusion

Our findings demonstrate the necessity of refined, more comparable assessment tools for evaluating potential risk factors.
Evaluation of high-resolution melt curve analysis for rapid differentiation of Campylobacter hepaticus from other species in birds
Authors: Young Petrina , Tarce Pol , Adhikary Sadhana , Connolly Joanne , Crawshaw Tim , Ghorashi Seyed A.
Published: May 2021

Spotty liver disease (SLD) is a bacterial disease of chicken, causing mortalities and reduction in egg production, hence, contributing to economic loss in the poultry industry. The causative agent of SLD has only recently been identified as a novel Campylobacter species, Campylobacter hepaticus. Specific primers were designed from the hsp60 gene of Campylobacter hepaticus and PCR followed by high-resolution melt curve analysis was optimised to detect and differentiate three species of Campylobacter (Campylobacter coli, Campylobacter jejuni and Campylobacter hepaticus). The three Campylobacter species produced a distinct curve profile and was differentiated using HRM curve analysis. The potential of the PCR-HRM curve analysis was shown in the genotyping of 37 Campylobacter isolates from clinical specimens from poultry farms. PCR-HRM curve analysis of DNA extracts from bile samples or cultures from bile samples, were identified as Campylobacter hepaticus and confirmed by DNA sequencing. The DNA sequence analysis of selected samples from each of the three HRM distinctive curves patterns showed that each DNA sequence was associated with a unique melt profile. The potential of the PCR-HRM curve analysis in genotyping of Campylobacter species was also evaluated using faecal specimens from 100 wild birds. The results presented in this study indicate that PCR followed by HRM curve analysis provides a rapid and robust technique for genotyping of Campylobacter species using either bacterial cultures or clinical specimens.
Inequality indices to monitor geographic differences in incidence, mortality and fatality rates over time during the COVID-19 pandemic
Authors: Manz Kirsi M. , Mansmann Ulrich
Published: May 2021

Background

It is of interest to explore the variability in how the COVID-19 pandemic evolved geographically during the first twelve months. To this end, we apply inequality indices over regions to incidences, infection related mortality, and infection fatality rates. If avoiding of inequality in health is an important political goal, a metric must be implemented to track geographical inequality over time.

Methods

The relative and absolute Gini index as well as the Theil index are used to quantify inequality. Data are taken from international data bases. Absolute counts are transformed to rates adjusted for population size.

Results

Comparing continents, the absolute Gini index shows an unfavorable development in four continents since February 2020. In contrast, the relative Gini as well as the Theil index support the interpretation of less inequality between European countries compared to other continents. Infection fatality rates within the EU as well as within the U.S. express comparable improvement towards more equality (as measured by both Gini indices).

Conclusions

The use of inequality indices to monitor changes in geographic inequality over time for key health indicators is a valuable tool to inform public health policies. The absolute and relative Gini index behave complementary and should be reported simultaneously in order to gain a meta-perspective on very complex dynamics.
Ethnic-specific reference range affects the efficacy of quadruple test as a universal screening for Down syndrome in a developing country
Authors: Pranpanus Savitree , Kor-anantakul Ounjai , Suntharasaj Thitima , Suwanrath Chitkasaem , Hanprasertpong Tharangrut , Pruksanusak Ninlapa , Petpichetchian Chusana , Suksai Manaphat , Chainarong Natthicha , Sawaddisan Rapphon
Published: May 2021

Objective

To evaluate the efficacy of the quadruple test for potential use as a Thai national policy for Down syndrome (DS) screening and establish an accurate equation for risk estimation of Down syndrome based on gestational age, weight and the ethnic-specific reference range of our population.

Methods

A prospective study was conducted on singleton pregnancies at 14 to 21 weeks of gestation to evaluate the efficacy of quadruple DS screening using the automatically calculated Western European descent factor (WF) in our population and the impact of screening using a specific Thai ethnic factor as well as to establish an equation for the risk estimation of DS based on gestational age, weight and a local Thai ethnic factor to correct for the impact of ethnic factor on the screening efficacy.

Results

Of a total of 5,515 women, 12 cases of DS and 8 cases of other aneuploidies were found. The detection rate, false positive rate and specificity were 75.0%, 9.1% and 90.9%, respectively, by automatic calculation with the widely used WF; the screening efficacy was lower when used in Asian populations than in other studies. The best-fitted regression equation of serum quadruple screening of AFP, free β-hCG, uE3 and inhibin A was established by adjustment for gestational age (GA) in days, maternal weight and our Thai-specific ethnic reference range which was created for this study. Calculations with our Thai-specific ethnic model gave a better detection rate of 83.3%, a false positive rate of 9.6% and specificity of 90.4%.

Conclusion

The serum quadruple test had a lower detection rate than expected when the risk estimation was based on the WF reference range. The serum quadruple test using WF had significantly different levels when corrected with our ethnic-specific factor. Using our local ethnic specific model could increase the detection rate of DS screening in Thailand with a minimal increase in false positive rates. Our findings indicate that DS screening should be adjusted with an appropriate individual ethnic factor when used for national screening.
Improving the diagnostic recognition of thoracic endometriosis: Spotlight on a new histo-morphological indicator
Authors: Okafor Okechukwu Charles , Ezemba Ndubueze , Onyishi Nnaemeka Thaddeus , Ezike Kevin Nwabueze
Published: May 2021

The diagnosis of thoracic endometriosis (TE) is challenging, hence resulting in under-diagnosis as well as long delays before arriving at a correct definitive diagnosis. Our aim is to review the histopathological findings in TE, summarise the diagnostic features, identify any major histo-morphological indicator(s) hitherto unrecognised as such, suggest diagnostic criteria; all with the aim of improving the diagnostic capacity and reducing observer error even where the clinical suspicion is low. A case-control study in which a search in the pathology archives of a referral hospital over a 10-year period was conducted. Twenty-six cases of TE were identified, reviewed, and compared with a control population of 48 cases taken from common benign thoracic diseases. Nine notable histological features were identified in varying permutations in the test group, namely: endometrioid glands, lymphoid clusters, ceroid macrophages, siderophages, cholesterol crystals, capillary congestion, multinucleated giant cells, smooth muscle bundles and fibrosis. The first 6 features were frequent; each being present in over 13 (13/26; 50%) test cases. The first 8 features showed significant association with TE by the Chi-squared test (P<0.05). In this group, the strength of association is high for the first 4 features (Cramér’s V≥0.5). The presence of ceroid macrophages is shown to be a novel key feature, previously unrecognised as such, for the identification of TE. The presence of any three of four features including endometrioid glands, lymphoid clusters, ceroid macrophages and siderophages is a suggested criterion for the definitive diagnosis of TE.
Finite element analysis of cutting balloon expansion in a calcified artery model of circular angle 180°: Effects of balloon-to-diameter ratio and number of blades facing calcification on potential calcification fracturing and perforation reduction
Authors: Zhu Xiaodong , Umezu Mitsuo , Iwasaki Kiyotaka
Published: May 2021

Calcified artery lesions cause stent under-expansion and increase the risk of in-stent restenosis and stent thrombosis. Cutting balloons facilitate the fracturing of calcification prior to stent implantation, although vessel dissection and perforation are potential issues. In clinical practice, calcifications having maximum calcium angles ≤ 180° are rarely fractured during conventional balloon angioplasty. We hypothesize that the lesion/device diameter ratio and the number of blades facing a non-circular calcified lesion may be crucial for fracturing the calcification while avoiding vessel injury. The geometries of the cutting balloons were constructed and their finite-element models were generated by folding and wrapping the balloon model. Numerical simulations were performed for balloons with five different diameters and two types of blade directions in a 180° calcification model. The calcification expansion ability was distinctly higher when two blades faced the calcification than when one blade did. Moreover, when two blades faced the calcification model, larger maximum principal stresses were generated in the calcification even when using undersized balloons with diameters reduced by 0.25 or 0.5 mm from the reference diameter, when compared with the case where one blade faced the calcified model and a balloon of diameter equal to the reference diameter was used. When two blades faced the calcification, smaller stresses were generated in the artery adjacent to the calcification; further, the maximum stress generated in the artery model adjacent to the calcification under the rated pressure of 12 atm when employing undersized balloons was smaller than that when only one blade faced the calcification and when lesion-identical balloon diameters were used under a nominal pressure of 6 atm. Our study suggested that undersized balloons of diameters 0.25 or 0.5 mm less than the reference diameter might be effective in not only expanding the calcified lesion but also reducing the risk of dissection.
Does perioperative respiratory event increase length of hospital stay and hospital cost in pediatric ambulatory surgery?
Authors: Oofuvong Maliwan , Geater Alan Frederick , Chongsuvivatwong Virasakdi , Chanchayanon Thavat , Sriyanaluk Bussarin , Suwanrat Boonthida , Nuanjun Kanjana
Published: May 2021

Objective

We examined the consequences of perioperative respiratory event (PRE) in terms of hospitalization and hospital cost in children who underwent ambulatory surgery.

Methods

This subgroup analysis of a prospective cohort study (ClinicalTrials.gov: NCT02036021) was conducted in children aged between 1 month and 14 years who underwent ambulatory surgery between November 2012 and December 2013. Exposure was the presence of PRE either intraoperatively or in the postanesthetic care unit or both. The primary outcome was length of stay after surgery. The secondary outcome was excess hospital cost excluding surgical cost. Financial information was also compared between PRE and non-PRE. Directed acyclic graphs were used to select the covariates to be included in the multivariate regression models. The predictors of length of stay and excess hospital cost between PRE and non-PRE children are presented as adjusted odds ratio (OR) and cost ratio (CR), respectively with 95% confidence interval (CI).

Results

Sixty-three PRE and 249 non-PRE patients were recruited. In the univariate analysis, PRE was associated with length of stay (p = 0.004), postoperative oxygen requirement (p <0.001), and increased hospital charge (p = 0.006). After adjustments for age, history of snoring, American Society of Anesthesiologists physical status, type of surgery and type of payment, preoperative planned admission had an effect modification with PRE (p <0.001). The occurrence of PRE in the preoperative unplanned admission was associated with 24-fold increased odds of prolonged hospital stay (p <0.001). PRE was associated with higher excess hospital cost (CR = 1.35, p = 0.001). The mean differences in contribution margin for total procedure (per patient) (PRE vs non-PRE) differed significantly (mean = 1,523; 95% CI: 387, 2,658 baht).

Conclusion

PRE with unplanned admission was significantly associated with prolonged length of stay whereas PRE regardless of unplanned admission increased hospital cost by 35% in pediatric ambulatory surgery.

Trial registration

ClinicalTrials.gov registration numberNCT02036021.
Effect of illumination level [18F]FDG-PET brain uptake in free moving mice
Authors: de Francisco Alexandra , Sierra-Palomares Yolanda , Felipe María , Calle Daniel , Desco Manuel , Cussó Lorena
Published: May 2021

In both clinical and preclinical scenarios, 2-deoxy-2[18F]fluoro-D-glucose ([18F]FDG) is the radiotracer most widely used to study brain glucose metabolism with positron emission tomography (PET). In clinical practice, there is a worldwide standardized protocol for preparing patients for [18F]FDG-PET studies, which specifies the room lighting. However, this standard is typically not observed in the preclinical field, although it is well known that animal handling affects the biodistribution of [18F]FDG. The present study aimed to evaluate the effect of ambient lighting on brain [18F]FDG uptake in mice. Two [18F]FDG-PET studies were performed on each animal, one in light and one in dark conditions. Thermal video recordings were acquired to analyse animal motor activity in both conditions. [18F]FDG-PET images were analysed with the Statistical Parametric Mapping method. The results showed that [18F]FDG uptake is higher in darkness than in light condition in mouse nucleus accumbens, hippocampus, midbrain, hindbrain, and cerebellum. The SPM analysis also showed an interaction between the illumination condition and the sex of the animal. Mouse activity was significantly different (p = 0.01) between light conditions (632 ± 215 s of movement) and dark conditions (989 ± 200 s), without significant effect of sex (p = 0.416). We concluded that room illumination conditions during [18F]FDG uptake in mice affected the brain [18F]FDG biodistribution. Therefore, we highlight the importance to control this factor to ensure more reliable and reproducible mouse brain [18F]FDG-PET results.
Long-term changes in body composition and their relationships with cardiometabolic risk factors: A population-based cohort study
Authors: Fan Zhaoyang , Shi Yunping , Huang Guimin , Hou Dongqing , Liu Junting
Published: May 2021

The aim of the present study was to classify the latent body fat trajectories of Chinese adults and their relationships with cardiometabolic risk factors. Data were obtained from the China Health Nutrition Survey for 3,013 participants, who underwent six follow-up visits between 1993 and 2009. Skinfold thickness and other anthropometric indicators were used to estimate body composition. The latent growth model was used to create fat mass to fat-free mass ratio (F2FFMR) trajectory groups. Blood pressure, fasting plasma glucose, total cholesterol, triglycerides, and high- and low-density lipoprotein–cholesterol were measured in venous blood after an overnight fast. Logistic regression was used to explore the relationships of F2FFMR trajectory with cardiometabolic risk factors. In men, four types of F2FFMR trajectory were identified. After adjustment for behavioral and lifestyle factors, age, and weight status, and compared with the Low stability group, the High stability group showed a significant association with diabetes. In women, three types of F2FFMR trajectory were identified. Compared to the Low stability group, the High stability group showed significant associations with diabetes and hypertension after adjustment for the same covariates as in men. Thus, in this long-term study we have identified three F2FFMR trajectory groups in women and four in men. In both sexes, the highly stable F2FFMR is associated with the highest risk of developing diabetes, independent of age and body mass. In addition, in women, it is associated with the highest risk of hypertension, independent of age and body mass.
Happy just because. A cross-cultural study on subjective wellbeing in three Indigenous societies
Authors: Reyes-García Victoria , Gallois Sandrine , Pyhälä Aili , Díaz-Reviriego Isabel , Fernández-Llamazares Álvaro , Galbraith Eric , Miñarro Sara , Napitupulu Lucentezza
Published: May 2021

While cross-cultural research on subjective well-being and its multiple drivers is growing, the study of happiness among Indigenous peoples continues to be under-represented in the literature. In this work, we measure life satisfaction through open-ended questionnaires to explore levels and drivers of subjective well-being among 474 adults in three Indigenous societies across the tropics: the Tsimane’ in Bolivian lowland Amazonia, the Baka in southeastern Cameroon, and the Punan in Indonesian Borneo. We found that life satisfaction levels in the three studied societies are slightly above neutral, suggesting that most people in the sample consider themselves as moderately happy. We also found that respondents provided explanations mostly when their satisfaction with life was negative, as if moderate happiness was the normal state and explanations were only needed when reporting a different life satisfaction level due to some exceptionally good or bad occurrence. Finally, we also found that issues related to health and–to a lesser extent–social life were the more prominent explanations for life satisfaction. Our research not only highlights the importance to understand, appreciate and respect Indigenous peoples’ own perspectives and insights on subjective well-being, but also suggests that the greatest gains in subjective well-being might be achieved by alleviating the factors that tend to make people unhappy.
Sequencing toponymic change: A quantitative longitudinal analysis of street renaming in Sibiu, Romania
Authors: Rusu Mihai Stelian
Published: May 2021

Recent scholarship in critical toponymy studies has refashioned the understanding of street names from innocent labels to nominal loci of historical memory and vectors of collective identity that are embroiled with power relations. Urban nomenclatures consist of more than mere linguistic signposts deployed onto space to facilitate navigation. Street names are also powerful signposts that indicate the political regime and its socio-cultural values. Drawing on these theoretical insights, this paper is focused on Sibiu (Romania) and explore the city’s shifting namescape in a longitudinal perspective spanning one century and a half of modern history (1875–2020). The analysis is based on a complete dataset of street names and street name changes registered across five political regimes (Habsburg Empire, Kingdom of Romania, Romanian People’s Republic, Socialist Republic of Romania, and post-socialist Romania). A series of multiple logistic regression models were carried out to determine the factors that influence toponymic change. The statistical results point out several significant predictors of street renaming: (1) the streets’ toponymic characteristics (politicized or neutral name); (2) artery rank (public squares and large avenues or ordinary streets and alleys); and (3) topographic features (a street’s size and centrality). Such a quantitative approach coupled with a longitudinal perspective contributes to the scholarly literature on place-naming practices in three major ways: firstly, by advancing an innovative methodological framework and analytical model for the study of street name changes; secondly, by delineating with statistical precision the factors that model toponymic change; and thirdly, by embedding these renaming practices observed especially after significant power shifts in the broader historical context of the changes brought in the city’s street nomenclature.
Evolution of default genetic control mechanisms
Authors: Bains William , Borriello Enrico , Schulze-Makuch Dirk
Published: May 2021

We present a model of the evolution of control systems in a genome under environmental constraints. The model conceptually follows the Jacob and Monod model of gene control. Genes contain control elements which respond to the internal state of the cell as well as the environment to control expression of a coding region. Control and coding regions evolve to maximize a fitness function between expressed coding sequences and the environment. The model was run 118 times to an average of 1.4∙106 ‘generations’ each with a range of starting parameters probed the conditions under which genomes evolved a ‘default style’ of control. Unexpectedly, the control logic that evolved was not significantly correlated to the complexity of the environment. Genetic logic was strongly correlated with genome complexity and with the fraction of genes active in the cell at any one time. More complex genomes correlated with the evolution of genetic controls in which genes were active (‘default on’), and a low fraction of genes being expressed correlated with a genetic logic in which genes were biased to being inactive unless positively activated (‘default off’ logic). We discuss how this might relate to the evolution of the complex eukaryotic genome, which operates in a ‘default off’ mode.
SARS-CoV-2 antibody immunoassays in serial samples reveal earlier seroconversion in acutely ill COVID-19 patients developing ARDS
Authors: Buchholtz Marie-Luise , Arend Florian M. , Eichhorn Peter , Weigand Michael , Kleinhempel Alisa , Häusler Kurt , Bruegel Mathias , Holdt Lesca M. , Teupser Daniel
Published: May 2021

Objectives

During the COVID-19 pandemic, SARS-CoV-2 antibody testing has been suggested for (1) screening populations for disease prevalence, (2) diagnostics, and (3) guiding therapeutic applications. Here, we conducted a detailed clinical evaluation of four Anti-SARS-CoV-2 immunoassays in samples from acutely ill COVID-19 patients and in two negative cohorts.

Methods

443 serum specimens from serial sampling of 29 COVID-19 patients were used to determine clinical sensitivities. Patients were stratified for the presence of acute respiratory distress syndrome (ARDS). Individual serum specimens from a pre-COVID-19 cohort of 238 healthy subjects and from a PCR-negative clinical cohort of 257 patients were used to determine clinical specificities. All samples were measured side-by-side with the Anti-SARS-CoV-2-ELISA (IgG), Anti-SARS-CoV-2-ELISA (IgA) and Anti-SARS-CoV-2-NCP-ELISA (IgG) (Euroimmun AG, Lübeck, Germany) and the Elecsys Anti-SARS-CoV-2 ECLIA (Roche Diagnostics International, Rotkreuz, Switzerland).

Results

Median seroconversion occurred earlier in ARDS patients (8–9 days) than in non-ARDS patients (11–17 days), except for EUR N-IgG. Rates of positivity and mean signal ratios in the ARDS group were significantly higher than in the non-ARDS group. Sensitivities between the four tested immunoassays were equivalent. In the set of negative samples, the specificity of the Anti-SARS-CoV-2-ELISA (IgA) was lower (93.9%) compared to all other assays (≥98.8%) and the specificity of Anti-SARS-CoV-2-NCP-ELISA (IgG) was lower (98.8%) than that of Elecsys Anti-SARS-CoV-2 (100%).

Conclusions

Serial sampling in COVID-19 patients revealed earlier seroconversion and higher signal ratios of SARS-CoV-2 antibodies as a potential risk marker for the development of ARDS, suggesting a utility for antibody testing in acutely diseased patients.
Non-linear optical imaging of atherosclerotic plaques in the context of SIV and HIV infection prominently detects crystalline cholesterol esters
Authors: Park Min Hi , Suhalim Jeffrey L. , Elmastour Firas , Singha Santu K. , Imafuku Tadashi , Venkatnarayan Ramanathan , Christ Anette , Grebe Alena , Oppelt Sarah A. , Sviridov Dmitri , Bukrinsky Michael , Latz Eicke , Potma Eric O. , Fitzgerald Michael L.
Published: May 2021

Chronic HIV infection may exacerbate atherosclerotic vascular disease, which at advanced stages presents as necrotic plaques rich in crystalline cholesterol. Such lesions can catastrophically rupture precipitating myocardial infarct and stroke, now important causes of mortality in those living with HIV. However, in this population little is known about plaque structure relative to crystalline content and its chemical composition. Here, we first interrogated plaque crystal structure and composition in atherosclerotic SIV-infected macaques using non-linear optical microscopy. By stimulated Raman scattering and second harmonic generation approaches both amorphous and crystalline plaque lipid was detected and the crystal spectral profile indicated a cholesterol ester (CE) dominated composition. Versus controls, SIV+ samples had a greater number of cholesterol crystals (CCs), with the difference, in part, accounted for by crystals of a smaller length. Given the ester finding, we profiled HIV+ plaques and also observed a CE crystalline spectral signature. We further profiled plaques from Ldlr-/- mice fed a high fat diet, and likewise, found CE-dominate crystals. Finally, macrophage exposure to CCs or AcLDL induced auto-fluorescent puncta that co-stained with the LC3B autophagy sensor. In aggregate, we show that atheromatous plaques from mice, macaques and humans, display necrotic cores dominated by esterified CCs, and that plaque macrophages may induce autophagic vesicle formation upon encountering CCs. These findings help inform our knowledge of plaque core lipid evolution and how the process may incite systemic inflammation.
Exposure misclassification bias in the estimation of vaccine effectiveness
Authors: Baum Ulrike , Kulathinal Sangita , Auranen Kari
Published: May 2021

In epidemiology, a typical measure of interest is the risk of disease conditional upon exposure. A common source of bias in the estimation of risks and risk ratios is misclassification. Exposure misclassification affects the measurement of exposure, i.e. the variable one conditions on. This article explains how to assess biases under non-differential exposure misclassification when estimating vaccine effectiveness, i.e. the vaccine-induced relative reduction in the risk of disease. The problem can be described in terms of three binary variables: the unobserved true exposure status, the observed but potentially misclassified exposure status, and the observed true disease status. The bias due to exposure misclassification is quantified by the difference between the naïve estimand defined as one minus the risk ratio comparing individuals observed as vaccinated with individuals observed as unvaccinated, and the vaccine effectiveness defined as one minus the risk ratio comparing truly vaccinated with truly unvaccinated. The magnitude of the bias depends on five factors: the risks of disease in the truly vaccinated and the truly unvaccinated, the sensitivity and specificity of exposure measurement, and vaccination coverage. Non-differential exposure misclassification bias is always negative. In practice, if the sensitivity and specificity are known or estimable from external sources, the true risks and the vaccination coverage can be estimated from the observed data and, thus, the estimation of vaccine effectiveness based on the observed risks can be corrected for exposure misclassification. When analysing risks under misclassification, careful consideration of conditional probabilities is crucial.
Psychosocial effects of the COVID-19 pandemic and lockdown on university students: Understanding apprehensions through a phenomenographic approach
Authors: Shahbaz Sumbal , Ashraf Muhammad Zeshan , Zakar Rubeena , Fischer Florian , Zakar Muhammad Zakria
Published: May 2021

Limited evidence exists to help understand the experiences of university students in relation to the long-term lockdown due to the COVID-19 pandemic. For that reason, we conducted a study using a phenomenographic approach in order to understand how university students perceive COVID-19 and the associated lockdown. Data were collected from 25 students in Pakistan. They were asked to demonstrate the psychological effects of the COVID-19 pandemic and lockdown in illustrations. In addition, in-depth interviews were conducted with these students, to gain further insights into their perspectives on the psychosocial effects of the COVID-19 pandemic. The analysis revealed four interlinked directions for understanding students’ experiences. These themes were: 1) escape into peace, 2) hope for personal freedom, 3) fear of becoming a victim of COVID-19, and 4) concerns regarding education, future career, and opportunities. All four themes were analyzed and condensed into an outcome space, which further gathers the perceptions of students under one theme as “Hope for life while paradoxically living with fear”. Studying the psychological impact of the COVID-19 pandemic and lockdown on students not only highlighted their concerns, but also emphasized the importance of starting regular psychological evaluations and stress-releasing sessions, along with online education to overcome growing depression.