bluuebunny/crossref_metadata_2025 huggingface dataset:
The combination of experimental periodontitis and oral microbiota from periodontitis patients aggravates liver fibrosis in mice
Authors: Bai Lan , Wang Yong‐Li , Chen Yan‐Lin , Li Hu‐Xiao , Zhu Shi‐Wei , Liu Yan , Song Zhong‐Chen , Duan Sheng‐Zhong
Published: June 2022

Aim

Periodontitis (PD) is the sixth most prevalent disease around the world and is involved in the development and progression of multiple systemic diseases. Previous studies have reported that PD may aggravate liver injuries. The objective of this study was to investigate whether and how PD affects liver fibrosis.

Materials and Methods

Ligature‐induced PD (LIP) was induced in male C57/B6J mice, and sub‐gingival plaques (PL) from patients with PD were applied to mouse teeth. Liver fibrosis was induced by carbon tetrachloride (CCl4) injection. The mice were randomly divided into six groups: Oil, Oil+LIP, Oil+LIP+PL, CCl4, CCl4+LIP, and CCl4+LIP+PL. Alveolar bone resorption was evaluated by methylene blue staining. Hepatic function was analysed by serum alanine aminotransferase and hepatic hydroxyproline. Picrosirius red and α‐smooth muscle actin (SMA) staining were used to evaluate the fibrotic area. RNA sequencing and quantitative RT‐PCR were used to measure gene expression. Western blotting was used to measure protein levels. Flow cytometry was used to analyse the accumulation of immune cells. Mouse microbiota were analysed using 16S rRNA gene sequencing.

Results

Mice in the CCl4+LIP+PL group displayed higher serum alanine aminotransferase and hepatic hydroxyproline as well as more Picrosirius red‐positive and α‐SMA‐positive areas in liver samples than those of the CCl4 group, suggesting that PD (LIP+PL) aggravated CCl4‐induced hepatic dysfunction and liver fibrosis. Consistently, the expression of fibro‐genic genes and the protein levels of transforming growth factor β were much higher in the CCl4+LIP+PL group than in the CCl4 group. Flow cytometry revealed that PD increased the accumulation of immune cells, including Kupffer cells, B cells, and Th17 cells, in the liver of mice with CCl4 treatment. PD also increased the expression of inflammatory genes and activated pro‐inflammatory nuclear factor‐kappa B pathway in the livers of CCl4‐injected mice. Moreover, PD altered both oral and liver microbiota in CCl4‐injected mice.

Conclusions

PD aggravates CCl4‐induced hepatic dysfunction and fibrosis in mice, likely through the increase of inflammation and alteration of microbiota in the liver.
Prenatal Considerations and Outcomes for Girls Aged 14 and Under: Development of a Multidisciplinary Team in a Large Tertiary Care Facility
Authors: Fairchild Esther , Kyle Sara , Marion Shirley , Cheatham Allyson , Lecky Tashein , Harris Shalawn , Jensen Sarah
Published: June 2022

Introduction

Adolescent girls account for 11% of all births that occur globally every year. Among developing countries, the United States continues to have one of the highest adolescent birth rates, despite a decreasing trend between 1990 and 2010. Pregnant adolescents are a vulnerable population who are at increased risk for maternal morbidity and mortality. Additional risks are noted within the early adolescent population, usually defined as age 10 to 14.

Process

At Parkland hospital, a large tertiary care facility in Dallas, Texas, a multidisciplinary team was created in 2017 to care for this vulnerable population. The team consisted of a certified nurse‐midwife (CNM), a Certified Child Life Specialist, a maternal fetal medicine physician, a social worker, and a Spanish interpreter, with additional services consulted as needed. Between 2017 and 2020, this team grew to include 8 CNMs and provided care to 76 young adolescents ages 14 and younger.

Outcomes

Of the young adolescents who attended prenatal visits with the Adolescent Prenatal Care Team at Parkland, 87% presented to Parkland for birth. Eighteen percent had pregnancy‐induced hypertension or eclampsia. Only 7% of adolescents in the program gave birth prior to 37 weeks. Seventy‐four percent had vaginal births. Sixty percent of the adolescents attended known postpartum visits.

Discussion

In contrast to most studies, this Adolescent Care Team did not find a high rate of premature birth in early adolescents. Further work by this team is needed to compare the data obtained during this period with data on similar adolescents who have given birth at Parkland in prior years. In addition, comparing outcomes of early adolescents with those aged 15 to 19, who were not included in the Adolescent Care Team, will help to understand the impact that such a team or similar intervention might have on this vulnerable population.
The risk of renal comorbidities in celiac disease patients depends on the phenotype of celiac disease
Authors: Nurmi Rakel , Pasternack Camilla , Salmi Teea , Hervonen Kaisa , Koskinen Inka , Järvelin Jutta , Huhtala Heini , Collin Pekka , Mustonen Jukka , Kaukinen Katri , Mäkelä Satu
Published: June 2022

Background

An increased risk of kidney disease in patients with celiac disease has been reported, but the association has remained obscure. Only few studies have investigated the association between renal comorbidities and dermatitis herpetiformis, a cutaneous manifestation of celiac disease.

Objectives

We investigated whether patients with different phenotypes of celiac disease are at higher risk of kidney diseases than age‐ and sex‐matched references.

Methods

The diagnoses of glomerulonephritis, diabetic nephropathy, interstitial nephritis, and end‐stage renal disease obtained from the National Hospital Discharge Register between 1970 and 2015 were identified in celiac disease (Marsh III, n = 1072) and dermatitis herpetiformis (n = 368) patients diagnosed at Tampere University Hospital catchment region and in 4296 reference subjects. Using the Cox proportional hazards model, we compared the risk of kidney diseases between patients and references. The study protocol was approved by the Regional Ethics Committee of Tampere University Hospital (R16090). As the study was register based, no consent from patients was required.

Results

Even after adjusting for type 1 diabetes, celiac disease was associated with an elevated risk of kidney disease (hazard ratio [HR] 1.85, 95% confidence interval [CI] 1.12–3.03), glomerulonephritis (HR 3.37, 95% CI 1.64–6.95), and IgA nephropathy (IgAN) (HR 18.98, 95% CI 2.29–157.63). No similarly elevated risk was found among dermatitis herpetiformis patients (HR 1.50, 95% CI 0.63–3.55; HR 2.21, 95% CI 0.77–6.38; and HR 5.87, 95% CI 0.53–64.79, respectively).

Conclusion

Celiac disease patients were at increased risk of kidney diseases, notably IgAN. The risk was dependent on the celiac disease phenotype and was not seen in patients with dermatitis herpetiformis. Awareness of possible renal manifestations is recommended when treating celiac disease patients.
‘We're all Born Naked and the Rest is Drag’: Spectacularization of Core Stigma in RuPaul's Drag Race
Authors: Campana Mario , Duffy Katherine , Micheli Maria Rita
Published: June 2022

How can organizations capitalize on core stigma through spectacles? In this paper, we adopt a performativity perspective to address this question. Specifically, we analyze how an assemblage of different actors within and around an organization contributes to the spectacularization of stigma and thus brings a new reality into being. In this new reality, rather than stigma being concealed, it is normalized, and the organization capitalizes on it to enhance success. We focus on RuPaul's Drag Race as a stigmatized organization that has built its success through the active spectacularization of its core stigma. In our analyses, we identify three mechanisms (i.e., reiteration of transgressions, awakening of social consciousness, and language modelling) the organization strategically uses to spectacularize the transgressions associated with the social deviance of drag queens. Through these mechanisms, a new reality around the stigma of drag queens is constructed and stigma is normalized. Overall, we contribute to a better understanding of how organizations can capitalize on their core stigma through spectacularization; we also explore the role of audiences in co‐creating organizational realities around stigma.
Women, work, and families during the COVID‐19 pandemic: Examining the effects of COVID policies and looking to the future
Authors: Hayes Amy Roberson , Lee Diamond
Published: June 2022

The far‐reaching, negative effects of the COVID‐19 pandemic have impacted healthcare, economic, public safety, and social systems globally. The public safety measures put in place in the United States during the COVID‐19 pandemic, including sheltering in places orders and shutdowns of schools and places of work, negatively impacted the employment status and increased time spent in domestic work and childcare for women. In this paper, we review and analyze the impacts, both direct and indirect, of COVID‐related policies on the lives of women. Specifically, we outline how the progression of policies aimed at addressing both public safety and economic recovery during the COVID‐19 pandemic affected women's health, paid and unpaid work, and wellbeing. We will focus on the impacts of policies implemented in the United States in comparison to policies that were implemented globally to address similar issues during the first two years of the COVID‐19 pandemic. Finally, we conclude with recommendations for policies that could prevent similar disparate impacts on women in future crises.
Structure analysis and quality evaluation of plant‐based meat analogs
Authors: Fu Jialing , Sun Cuixia , Chang Yuyang , Li Saiya , Zhang Yin , Fang Yapeng
Published: June 2022

The growing world's population increases the demand of proteins. Meat products as the major source of high protein food are facing environmental impacts and animal welfare issues. Therefore, plant‐based meat analogs are developed and gain a foothold in global markets. The structure design, sensory attributes and nutrient characteristics of meat analogs are crucial points to match the real meat. This review aimed to systematically introduce the structural analysis methods and evaluate meat analog products from quality‐related attributes. First, various strategies of analyzing the fibrous structure of meat analogs were illustrated, including microscopic imaging and several optical techniques. Then, representative techniques such as NMR and AFM‐IR for analyzing the distribution of moisture and lipid in meat analogs are introduced. In terms of quality, we elaborated on the texture and sensory evaluation methods and dialectically analyzed meat analogs’ nutrition, which can provide a guidance for the advanced development of meat analogs.
Cirrhosis and fungal infections‐a cocktail for catastrophe: A systematic review and meta‐analysis with machine learning
Authors: Verma Nipun , Singh Shreya , Roy Akash , Valsan Arun , Garg Pratibha , Pradhan Pranita , Chakrabarti Arunaloke , Singh Meenu
Published: June 2022

Objectives

We evaluated the magnitude and factors contributing to poor outcomes among cirrhosis patients with fungal infections (FIs).

Methods

We searched PubMed, Embase, Ovid and WOS and included articles reporting mortality in cirrhosis with FIs. We pooled the point and relative‐risk (RR) estimates of mortality on random‐effects meta‐analysis and explored their heterogeneity (I
2) on subgroups, meta‐regression and machine learning (ML). We assessed the study quality through New‐Castle‐Ottawa Scale and estimate‐asymmetry through Eggers regression. (CRD42019142782).

Results

Of 4345, 34 studies (2134 patients) were included (good/fair/poor quality: 12/21/1). Pooled mortality of FIs was 64.1% (95% CI: 55.4–72.0, I
2: 87%, p < .01), which was 2.1 times higher than controls (95% CI: 1.8–2.5, I
2:89%, p < .01). Higher CTP (MD: +0.52, 95% CI: 0.27–0.77), MELD (MD: +2.75, 95% CI: 1.21–4.28), organ failures and increased hospital stay (30 vs. 19 days) were reported among cases with FIs. Patients with ACLF (76.6%, RR: 2.3) and ICU‐admission (70.4%, RR: 1.6) had the highest mortality. The risk was maximum for pulmonary FIs (79.4%, RR: 1.8), followed by peritoneal FIs (68.3%, RR: 1.7) and fungemia (55%, RR: 1.7). The mortality was higher in FIs than in bacterial (RR: 1.7) or no infections (RR: 2.9). Estimate asymmetry was evident (p < 0.05). Up to 8 clusters and 5 outlier studies were identified on ML, and the estimate‐heterogeneity was eliminated by excluding such studies.

Conclusions

A substantially worse prognosis, poorer than bacterial infections in cirrhosis patients with FIs, indicates an unmet need for improving fungal diagnostics and therapeutics in this population. ACLF and ICU admission should be included in the host criteria for defining IFIs.
Disease burden and demographic characteristics of mucormycosis: A nationwide population‐based study in Taiwan, 2006–2017
Authors: Shih Hsin‐I , Huang Yi‐Ting , Wu Chi‐Jung
Published: June 2022

Background

Epidemiological knowledge of mucormycosis obtained from national population‐based databases is scarce.

Objectives

This study aimed to depict the disease burden and demographics of mucormycosis in Taiwan by using the Taiwan National Health Insurance Research Database (NHIRD) and those of aspergillosis as a comparator.

Methods

Data from patients with either mucormycosis or aspergillosis from 2006 to 2017 identified with the International Classification of Diseases (ICD) codes were extracted from the NHIRD. The incidence, demographics and clinical data of both diseases were analysed.

Results

A total of 204 patients with mucormycosis and 2270 patients with aspergillosis who were hospitalised and treated with mould‐active antifungals between 2006 and 2017 were identified. The average annual incidence of aspergillosis (0.81 cases per 100,000 population [0.81/100,000]) was 11‐fold higher than that of mucormycosis (0.07/100,000). A significant increase in incidence was observed for aspergillosis (from 0.48/100,000 in 2006 to 1.19/100,000 in 2017, p < .0001) but not for mucormycosis (from 0.04/100,000 in 2006 to 0.11/100,000 in 2017, p = .07). The major underlying disease identified was diabetes mellitus (60.8%) for mucormycosis and malignant neoplasms (45.9%) for aspergillosis. The all‐cause 90‐day mortality rate was similar between mucormycosis and aspergillosis patients (39% vs. 37%, p = .60). For mucormycosis patients, multivariate analysis revealed that posaconazole use was associated with lower in‐hospital mortality (aOR 0.38; 95% CI 0.15–0.97; p = .04).

Conclusions

Mucormycosis is an uncommon fungal disease in Taiwan, occurring mostly in diabetic patients. However, the incidence might be underestimated due to limited diagnostics. Continuous surveillance might aid in delineating the evolving features of mucormycosis.
miR169o and ZmNF‐YA13 act in concert to coordinate the expression of ZmYUC1 that determines seed size and weight in maize kernels
Authors: Zhang Min , Zheng Hongyan , Jin Lian , Xing Lijuan , Zou Junjie , Zhang Lan , Liu Cuimei , Chu Jinfang , Xu Miaoyun , Wang Lei
Published: June 2022

MicroRNAs (miRNAs) play key regulatory roles in seed development and emerge as new key targets for engineering grain size and yield. The Zma‐miRNA169 family is highly expressed during maize seed development, but its functional roles in seed development remain elusive.

Here, we generated zma‐miR169o and ZmNF‐YA13 transgenic plants. Phenotypic and genetic analyses were performed on these lines. Seed development and auxins contents were investigated.

Overexpression of maize miRNA zma‐miR169o increases seed size and weight, whereas the opposite is true when its expression is suppressed. Further studies revealed that zma‐miR169 acts by negatively regulating its target gene, a transcription factor ZmNF‐YA13 that also plays a key role in determining seed size. We demonstrate that ZmNF‐YA13 regulates the expression of the auxin biosynthetic gene ZmYUC1, which modulates auxin levels in the early developing seeds and determines the number of endosperm cells, thereby governing maize seed size and ultimately yield.

Overall, our present study has identified zma‐miR169o and ZmNF‐YA13 that form a functional module regulating auxin accumulation in maize seeds and playing an important role in determining maize seed size and yield, providing a set of novel molecular tools for yield improvement in molecular breeding and genetic engineering.
Intra‐Operative Neurophysiological Monitoring in Patients with Intraspinal Abnormalities Undergoing Posterior Spinal Fusion
Authors: Qiu Junyin , Liu Wanyou , Shi Benlong , Li Yang , Yan Huang , Zhu Zezhang , Liu Zhen , Sun Xu , Qiu Yong
Published: June 2022

Objective

To analyze the intraoperative neurophysiological monitoring (IONM) data of patients with intraspinal abnormalities undergoing posterior spinal fusion and to determine how intraspinal abnormalities influence IONM results.

Methods

Patients with severe kyphoscoliosis and intraspinal abnormalities who underwent posterior spinal correction and fusion between September 2015 and January 2019 were retrospectively reviewed. Candidate intraspinal abnormalities included Chiari malformation, syringomyelia, split cord malformation, and tethered cord syndrome. Total intravenous anesthesia was administered, and no muscle relaxant or inhalation anesthesia was used for maintenance. IONM data, including somatosensory evoked potentials (SSEP) and motor evoked potentials (MEP), were recorded. The P37 and N50 latencies and amplitude were recorded for SSEP, whereas only the amplitude was recorded for MEP. The possible high‐risk factors for abnormal IONM results were analyzed.

Results

The current study included 87 patients (40 men, 47 women) with an average age of 20.2 ± 10.4 years. The etiologies were neuromuscular in 45 patients, idiopathic in four, and congenital in 38. A total of 136 intraspinal abnormalities were detected, including Chiari malformation in 33 patients, syringomyelia in 55, split‐cord malformation in 25, and tethered cord syndrome in 23. Forty patients had one intraspinal abnormality, whereas 47 patients had two or three intraspinal abnormalities. The monitorabilities were 87.4% and 97.7% for the SSEP and MEP, respectively. SSEP alerts were reported in five patients and MEP alerts in four patients, and new neurological deficits were observed in three patients postoperatively. The sensitivity and specificity were 100% and 97.3% for SSEP, and 100% and 98.8% for MEP, respectively. A significant difference in MEP amplitude between the concave and convex sides was observed, while significantly higher SSEP latency was observed on the concave side in patients with preoperative neurological deficits. There were 52 (59.8%) patients with abnormal IONM data. Preoperative neurological deficits (χ2 = 7.715, p = 0.005) and more than one intraspinal abnormality (χ2 = 9.186, p = 0.004) indicated a higher risk of abnormal IONM data.

Conclusions

IONM can be effectively used in patients with intraspinal abnormalities who undergo posterior spinal fusion. Patients with preoperative neurological deficits and more than one intraspinal abnormality have a higher risk of abnormal IONM monitoring.
Digital Elevation Model‐Assisted Aerial Triangulation Method On An Unmanned Aerial Vehicle Sweeping Camera System
Authors: Zhao Xinbo , Zhou Qi , Dong Jieke , Duan Yansong
Published: June 2022

The sweeping camera systems in the surveying and mapping industry are usually efficient in image acquisition, for the photography coverage of a single strip is relatively large. The triangulation angle of correspondence is overly tiny to adopt traditional block adjustment (BA). This study analysed the imaging principle of the Chinese APS7K comprehensive camera system and proposed an aerial triangulation method for the data this system acquired. The proposed method first determines the adjacent matrix from the POS data and trajectory information. The other part of the method is to overcome the weak relative geometry in a single strip by introducing the digital elevation model (DEM) data into the block adjustment scheme. The optimal solution of adjustment is obtained by iteratively solving the problem. We verified the optimisation's effectiveness by checking stitched orthophoto and check points from Google Earth. The results show that mosaic discrepancy is eliminated, the reprojection error is reduced to subpixel level, and positioning accuracy is better than 0.4 meter (ground sample distance is 0.2 meter) after adjustment with ground control points. Finally, the method’s shortcomings and prospects are summarized.
Electronic Absorption Spectroscopy and Photochemistry of Criegee Intermediates
Authors: Karsili Tolga N. V. , Marchetti Barbara , Lester Marsha I. , Ashfold Michael N. R.
Published: June 2022

Interest in Criegee intermediates (CIs), often termed carbonyl oxides, and their role in tropospheric chemistry has grown massively since the demonstration of laboratory‐based routes to their formation and characterization in the gas phase. This article reviews current knowledge regarding the electronic spectroscopy of atmospherically relevant CIs like CH2OO, CH3CHOO, (CH3)2COO and larger CIs like methyl vinyl ketone oxide and methacrolein oxide that are formed in the ozonolysis of isoprene, and of selected conjugated carbene‐derived CIs of interest in the synthetic chemistry community. Of the aforementioned atmospherically relevant CIs, all except CH2OO and (CH3)2COO exist in different conformers which, under tropospheric conditions, can display strikingly different thermal loss rates via unimolecular and bimolecular processes. Calculated photolysis rates based on their absorption properties suggest that solar photolysis will rarely be a significant contributor to the total loss rate for any CI under tropospheric conditions. Nonetheless, there is ever‐growing interest in the absorption cross sections and primary photochemistry of CIs following excitation to the strongly absorbing 1ππ* state, and how this varies with CI, with conformer and with excitation wavelength. The later part of this review surveys the photochemical data reported to date, including a range of studies that demonstrate prompt photo‐induced fission of the terminal O–O bond, and speculates about possible alternate decay processes that could occur following non‐adiabatic coupling to, and dissociation from, highly internally excited levels of the electronic ground state of a CI.
Expressive flexibility and health‐related quality of life: The predictive role of enhancement and suppression abilities and relationships with trait emotional intelligence
Authors: Quattropani Maria C. , Lenzo Vittorio , Sardella Alberto , Bonanno George A.
Published: June 2022

This study aims to examine the ability to flexibly enhance and suppress emotional expression, known as expressive flexibility, in relation to physical and psychological health, as well as trait emotional intelligence (EI). A sample of 503 Italian (Mage = 28.65 ± 9.26 years, 85.1% females) participants completed the Italian version of Flexible Regulation of Emotional Expression (FREE) Scale, the TEIQue‐SF, and the Short Form‐12 Health Survey. Confirmatory factor analysis indicated that the Italian version of FREE showed adequate psychometric properties. In both genders, results of correlational analyses indicated that enhancement ability was associated with well‐being, emotionality, and sociability, whereas suppression ability was associated with self‐control. Regression analyses, controlling for age and gender, indicated that suppression and inversely enhancement abilities, predicted the perceived psychological but not physical health. Well‐being, self‐control, and sociability also contributed to explaining variance in the model. The interaction effect of enhancement and suppression was not significantly associated with either physical or psychological health. Overall, these results suggest that enhancement and suppression abilities differentially contribute to psychological health when trait EI is accounted for. Clinical implications and future directions for research on expressive flexibility are discussed.
On the haemodynamic consequence of the chemoreflex and muscle mechanoreflex interaction in women and men: two tales, one story
Authors: Wan Hsuan‐Yu , Weavil Joshua C. , Thurston Taylor S. , Georgescu Vincent P. , Morrissey Candice K. , Amann Markus
Published: June 2022

The cardiovascular response resulting from the individual activation of the muscle mechanoreflex (MMR) or the chemoreflex (CR) is different between men and women. Whether the haemodynamic consequence resulting from the interaction of these sympathoexcitatory reflexes is also sex‐dependent remains unknown. MMR and CR were activated by passive leg movement (LM) and exposure to hypoxia (O2‐CR) or hypercapnia (CO2‐CR), respectively. Twelve young men and 12 young women completed two experimental protocols: (1) resting in normoxia (PETO2: ∼83 mmHg, PETCO2: ∼34 mmHg), normocapnic hypoxia (PETO2: ∼48 mmHg, PETCO2: ∼34 mmHg) and hyperoxic hypercapnia (PETO2: ∼524 mmHg, PETCO2: ∼44 mmHg); (2) LM under the same gas conditions. During the MMR:O2‐CR coactivation, in men, the observed mean arterial pressure (MAP) and cardiac output (CO) were not different (additive effect), while the observed leg blood flow (LBF) and vascular conductance (LVC) were significantly lower (hypo‐additive), compared with the sum of the responses elicited by each reflex alone. In women, the observed MAP was not different (additive) while the observed CO, LBF and LVC were significantly greater (hyper‐additive), compared with the summated responses. During the MMR:CO2‐CR coactivation, in men, the observed MAP, CO and LBF were not different (additive), while the observed LVC was significantly lower (hypo‐additive), compared with the summated responses. In women, the observed MAP was significantly higher (hyper‐additive), while the observed CO, LBF and LVC were not different (additive), compared with the summated responses. The interaction of the MMR and CR has a pronounced influence on the autonomic cardiovascular control, with the haemodynamic consequences differing between men and women.

image

Key points

The cardiovascular response resulting from the activation of the muscle mechanoreflex (MMR) or the chemoreflex (CR) was previously shown to be different between women and men; this study focused on the haemodynamic consequence of the interaction of these two sympathoexcitatory reflexes.

MMR and CR were activated by passive leg movement and exposure to hypoxia (O2‐CR) or hypercapnia (CO2‐CR), respectively.

Individual and interactive reflex effects on central and peripheral haemodynamics were quantified in healthy young women and men.

In men, the MMR:O2‐CR and MMR:CO2‐CR interactions restricted peripheral haemodynamics, likely by potentiating sympathetic vasoconstriction.

In women, the MMR:O2‐CR interaction facilitated central and peripheral haemodynamics, likely by potentiating sympathetic vasodilatation; however, the MMR:CO2‐CR interaction was simply additive for the central and peripheral haemodynamics.

The interaction between the MMR and the CR exerts a profound influence on the autonomic control of cardiovascular function in humans, with the haemodynamic consequences differing between women and men.
Design and Optimization of Energy Consumption for a Low-Rise Building With Seasonal Variations Under Composite Climate of India
Authors: Verma Rahul , Kumar Sumit , Rakshit Dibakar , Premachandran B.
Published: June 2022

The need for maintaining thermal comfort conditions inside the building is a significant contributor to the total energy requirements of the buildings. Thus far, limited research has offered some strategies to mitigate the effect of ambient conditions on the thermal comfort and the building energy requirements for composite climatic zone in India. In order to address this problem, this study was conducted to evaluate and analyze the impacts of four different passive design strategies, i.e., insulation, cool roof, phase change material (PCM) thermal storage system, and shading, on thermal comfort and energy demand in the two-storey building situated in the composite climate zone of Delhi, India. The results obtained by numerical simulation for four different cities, i.e., Delhi, Jaipur, Lucknow, and Indore, have been compared to study the effect of local climatic and seasonal variations within the composite climatic zones. The simulations were conducted using the Design Builder software to capture results for one year. The results indicate that no single passive design strategy is sufficient to maintain comfortable conditions inside the building. The cool roof provides significant benefits in combination with other passive technologies in all seasons except for December, January, and February. The combination of insulation and PCM is useful for winter conditions. Energy saving of up to 20.5% is possible using the combination of all four passive strategies, whereas the cool roof alone gives an 18% reduction in energy load. The PCM with a melting point of about 32 °C is suggested for the cities under study.
Amphotericin B assembles into seven-molecule ion channels: An NMR and molecular dynamics study
Authors: Umegawa Yuichi , Yamamoto Tomoya , Dixit Mayank , Funahashi Kosuke , Seo Sangjae , Nakagawa Yasuo , Suzuki Taiga , Matsuoka Shigeru , Tsuchikawa Hiroshi , Hanashima Shinya , Oishi Tohru , Matsumori Nobuaki , Shinoda Wataru , Murata Michio
Published: June 2022

Amphotericin B, an antifungal drug with a long history of use, forms fungicidal ion-permeable channels across cell membranes. Using solid-state nuclear magnetic resonance spectroscopy and molecular dynamics simulations, we experimentally elucidated the three-dimensional structure of the molecular assemblies formed by this drug in membranes in the presence of the fungal sterol ergosterol. A stable assembly consisting of seven drug molecules was observed to form an ion conductive channel. The structure is somewhat similar to the upper half of the barrel-stave model proposed in the 1970s but substantially different in the number of molecules and in their arrangement. The present structure explains many previous findings, including structure-activity relationships of the drug, which will be useful for improving drug efficacy and reducing adverse effects.
Structure of the rabies virus glycoprotein trimer bound to a prefusion-specific neutralizing antibody
Authors: Callaway Heather M. , Zyla Dawid , Larrous Florence , de Melo Guilherme Dias , Hastie Kathryn M. , Avalos Ruben Diaz , Agarwal Alyssa , Corti Davide , Bourhy Hervé , Saphire Erica Ollmann
Published: June 2022

Rabies infection is nearly 100% lethal if untreated and kills more than 50,000 people annually, many of them children. Existing rabies vaccines target the rabies virus glycoprotein (RABV-G) but generate short-lived immune responses, likely because the protein is heterogeneous under physiological conditions. Here, we report the 3.39 Å cryo–electron microscopy structure of trimeric, prefusion RABV-G complexed with RVA122, a potently neutralizing human antibody. RVA122 binds to a quaternary epitope at the top of RABV-G, bridging domains and stabilizing RABV-G protomers in a prefusion state. RABV-G trimerization involves side-to-side interactions between the central α helix and adjacent loops, rather than contacts between central helices, and interactions among the fusion loops at the glycoprotein base. These results provide a basis from which to develop improved rabies vaccines based on RABV-G stabilized in the prefusion conformation.
Supplemental Material: Miocene terrestrial paleoclimates inferred from pollen in the Monterey Formation, Naples Coastal Bluffs section, California
Authors: Barron John A , al. et.
Published: June 2022

Pollen count data are provided in Supplemental Tables 1–3 
Emergency care in hospitals is as good at the weekend as on weekdays
Authors: Saul Helen , Gursul Deniz , Bion Julian
Published: June 2022

The study

Bion J, Aldridge C, Beet C, et al. Increasing specialist intensity at weekends to improve outcomes for patients undergoing emergency hospital admission: the HiSLAC two-phase mixed-methods study.
HSDR
2021;9:13.

To read the full NIHR Alert, go to:
https://evidence.nihr.ac.uk/alert/hospital-emergency-care-is-as-good-at-the-weekend-as-on-weekdays/
Protocol for process evaluation of SMART Mental Health cluster randomised control trial: an intervention for management of common mental disorders in India
Authors: Mukherjee Ankita , Daniel Mercian , Kallakuri Sudha , Kaur Amanpreet , Devarapalli Siddhardha , Raman Usha , Thornicroft Graham , Essue Beverley M , Praveen D , Sagar Rajesh , Kant Shashi , Saxena Shekhar , Patel Anushka , Peiris David , Maulik Pallab K
Published: June 2022

Introduction

In India about 95% of individuals who need treatment for common mental disorders like depression, stress and anxiety and substance use are unable to access care. Stigma associated with help seeking and lack of trained mental health professionals are important barriers in accessing mental healthcare. Systematic Medical Appraisal, Referral and Treatment (SMART) Mental Health integrates a community-level stigma reduction campaign and task sharing with the help of a mobile-enabled electronic decision support system (EDSS)—to reduce psychiatric morbidity due to stress, depression and self-harm in high-risk individuals. This paper presents and discusses the protocol for process evaluation of SMART Mental Health.

Methods and analysis

The process evaluation will use mixed quantitative and qualitative methods to evaluate implementation fidelity and identify facilitators of and barriers to implementation of the intervention. Case studies of six intervention and two control clusters will be used. Quantitative data sources will include usage analytics extracted from the mHealth platform for the trial. Qualitative data sources will include focus group discussions and interviews with recruited participants, primary health centre doctors, community health workers (Accredited Social Health Activits) who participated in the project and local community leaders. The design and analysis will be guided by Medical Research Council framework for process evaluations, the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework, and the normalisation process theory.

Ethics and dissemination

The study has been approved by the ethics committee of the George Institute for Global Health, India and the Institutional Ethics Committee, All India Institute of Medical Sciences (AIIMS), New Delhi. Findings of the study will be disseminated through peer-reviewed publications, stakeholder meetings, digital and social media platforms.

Trial registration number

CTRI/2018/08/015355.
Exploring the potential impact of the proposed UK TV and online food advertising regulations: a concept mapping study
Authors: Forde Hannah , Boyland Emma J , Scarborough Peter , Smith Richard , White Martin , Adams Jean
Published: June 2022

Objectives

In July 2020 the UK Government announced an intention to restrict advertisements for products high in fat, salt or sugar on live broadcast, catch-up and on-demand television before 21:00 hours; and paid for online advertising. As no other jurisdiction has implemented similar regulations, there is no empirical evidence about how they might perturb the food system. To guide the regulations’ implementation and evaluation, we aimed to develop a concept map to hypothesise their potential consequences for the commercial food system, health and society.

Methods

We used adapted group concept mapping in four virtual workshops with food marketing and regulation experts across academia, civil society, government organisations, and industry (n=14), supported by Miro software. We merged concepts derived from the four workshops to develop a master map and then invited feedback from participants via email to generate a final concept map.

Results

The concept map shows how the reactions of stakeholders to the regulations may reinforce or undermine the impact on the commercial food system, health and society. The map shows adaptations made by stakeholders that could reinforce, or undermine, positive impacts on public health. It also illustrates potential weaknesses in the design and implementation of the regulations that could result in little substantial difference to public health.

Conclusions

Prior to the regulations’ initial implementation or subsequent iterations, they could be altered to maximise the potential for reinforcing adaptations, minimise the potential for undermining adaptations and ensure they cover a wide range of advertising opportunities and foods. The concept map will also inform the design of an evaluation of the regulations and could be used to inform the design and evaluation of similar regulations elsewhere.
Preidentification of high-risk pregnancies to improve triaging at the time of admission and management of complications in labour room: a quality improvement initiative
Authors: Kumari Prabha , Singh Mahtab , Sinha Shailja , Ranjan Rajeev , Arora Prachi , Rani Sunita , Aggarwal Aparna , Aggarwal Kanika , Gupta Shefali
Published: June 2022

Complications can occur anytime during pregnancy and childbirth. Pregnancies associated with high-risk factors have a higher-than-normal risk for fetomaternal complications. Bhagwan Mahavir hospital is a public sector hospital catering to low-risk and high-risk pregnant women (PW) in the labour room (LR)). The obstetrics and gynaecology team observed that at times the LR team failed to identify high-risk pregnancy (HRP) during admission in LR and to manage complications timely and efficiently. Therefore, the team started a quality improvement (QI) project in January 2019 with the aim to admit preidentified HRP in LR from existing 0% to 80% in 3 months.

The QI team followed the point-of-care quality improvement methodology to conduct this improvement process. They identified HRP in the outpatient department (OPD) during their antenatal care (ANC) visits, mentioned an HRP number on their ANC cards, and did risk stratification with yellow and red stickers into moderate and severe HRP respectively. Preidentified HRP were attended, admitted and managed on priority in the LR. The team achieved its aim in the ninth week of the QI initiative and sustaining to date. The team also measured and analysed the type of HRP identified in OPD, complications occurring around the process of childbirth in LR, maternal near-miss, maternal death and PW referred out from LR. They observed a 6.5%-point reduction (68.93%) in the median complication rate of major life-threatening complications following this improvement process.

This new intervention facilitated the team in early initiation of management of HRP in OPD, their triaging in LR, preparedness towards managing complications, involvement of support staff, PW and their relatives in the patient care, and redistribution of human resources according to priority area. The lessons learnt are generalisable and can be used in other facilities with similar settings.
Neutrophil lymphocyte ratio as an indicator for disease progression in Idiopathic Pulmonary Fibrosis
Authors: Achaiah Andrew , Rathnapala Amila , Pereira Andrea , Bothwell Harriet , Dwivedi Kritica , Barker Rosie , Iotchkova Valentina , Benamore Rachel , Hoyles Rachel K , Ho Ling-Pei
Published: June 2022

Rationale

Idiopathic pulmonary fibrosis (IPF) is a progressive fibrotic lung disease. Patients present at different stages and disease course is varied. Blood monocytes have been linked to all-cause mortality, and neutrophils to progression to IPF in patients with the indeterminate for usual interstitial pneumonia CT pattern.

Objective

To determine association between blood monocytes, neutrophils and lymphocytes levels (and their derived indexes), with lung function decline and mortality in IPF.

Methods

We performed a retrospective analysis of an IPF cohort (n=128) who had their first clinical visit at the Oxford Interstitial Lung Disease Service between 2013 and 2017. Association between blood monocytes, neutrophils, lymphocytes and derived indexes (within 4 months of visit) and decline in forced vital capacity (FVC) and all-cause mortality were assessed using Cox proportional hazard regression analysis. Kaplan-Meier analysis was used to assess time-to-event for 10% FVC decline and mortality for patients dichotomised to high and low leucocyte counts.

Results

Median length of follow-up was 31.0 months (IQR 16.2–42.4); 41.4% demonstrated FVC decline >10% per year and 43.8% died. In multivariate models (incorporating age, gender and initial FVC%), raised neutrophils, lymphopaenia and neutrophil:lymphocyte ratio were associated with FVC decline (p≤0.01); while both monocytes and neutrophil levels (and their derived indexes) were associated with all-cause mortality (p≤0.01). Kaplan-Meier analysis also showed association between neutrophils and its derived indexes but not monocyte, with FVC decline.

Conclusion

Blood neutrophil and lymphopaenia are more sensitive than monocytes as prognostic indicators of disease progression in those with established IPF.
Severe vitamin D deficiency in patients admitted to the emergency department with severe sepsis is associated with an increased 90-day mortality
Authors: Malinverni Stefano , Ochogavia Queitan , Lecrenier Sarah , Scorpinniti Margherita , Preiser Jean-Charles , Cotton Frederic , Mols Pierre , Bartiaux Magali
Published: June 2022

Background

The role of vitamin D in the response to infection has been increasingly acknowledged. However, the influence of severe vitamin D deficiency on the outcome of patients admitted for severe sepsis is unknown. Hence, this study aimed to investigate the association between severe vitamin D deficiency and sepsis-related outcomes in patients presenting to the ED.

Methods

This single centre prospective study included patients presenting to the ED with severe sepsis from April 2014 until December 2017. 25-Hydroxy vitamin D (25(OH)D) was measured in a blood sample drawn within 24 hours of admission to the ED, and severe vitamin D deficiency was defined as 25(OH)D <12 ng/mL. 90-day mortality was compared between patients with and without severe vitamin D deficiency by a multivariable analysis adjusting for confounders and according to a Kaplan-Meier survival analysis.

Results

263 patients were initially screened and 164 patients with severe sepsis were included in this study, 18% of whom had septic shock. Severe vitamin D deficiency was present in 46% of patients. The overall 90-day mortality rate was 26.2% and the median length of stay was 14 days. In a logistic regression accounting for sepsis severity and age-adjusted comorbidities, severe vitamin D deficiency was associated with increased mortality (OR=2.69 (95% CI 1.03 to 7.00), p=0.043), and lower chances of hospital discharge (sub-HR=0.66 (95% CI 0.44 to 0.98)). In the subgroup of patients admitted to the intensive care unit, severe vitamin D deficiency was associated with an increased 28-day adjusted mortality (HR=3.06 (95% CI 1.05 to 8.94), p=0.04) and lower chances of discharge (sub-HR=0.51 (95% CI 0.32 to 0.81)).

Conclusions

Severe vitamin D deficiency at ED admission is associated with higher mortality and longer hospital stay in patients with severe sepsis.
iRECIST and atypical patterns of response to immuno-oncology drugs
Authors: Ramon-Patino Jorge Luis , Schmid Sabine , Lau Sally , Seymour Lesley , Gaudreau Pierre-Olivier , Li Janice Juan Ning , Bradbury Penelope Ann , Calvo Emiliano
Published: June 2022

With the advent of immunotherapy as one of the keystones of the treatment of our patients with cancer, a number of atypical patterns of response to these agents has been identified. These include pseudoprogression, where the tumor initially shows objective growth before decreasing in size, and hyperprogression, hypothesized to be a drug-induced acceleration of the tumor burden. Despite it being >10 years since the first immune-oncology drug was approved, neither the biology behind these paradoxical responses has been well understood, nor their incidence, identification criteria, predictive biomarkers, or clinical impact have been fully described. Immune-based Response Evaluation Criteria in Solid Tumors (iRECIST) guidelines have been published as a revision to the RECIST V.1.1 criteria for use in trials of immunotherapeutics, and the iRECIST subcommittee (of the RECIST Working Group) is working on elucidating these aspects, with data sharing a current major challenge to move forward with this unmet need in immuno-oncology.
Effects of hypnosis versus enhanced standard of care on postoperative opioid use after total knee arthroplasty: the HYPNO-TKA randomized clinical trial
Authors: Markovits Jessie , Blaha Ondrej , Zhao Emma , Spiegel David
Published: June 2022

Background

Hypnosis decreases perioperative pain and has opioid-sparing potential but has not been rigorously studied in knee arthroplasty. This trial investigates the impact of perioperative hypnosis on inpatient opioid use following total knee arthroplasty.

Methods

This prospective randomized controlled trial was conducted at a single academic medical center. The hypnosis arm underwent a scripted 10 min hypnosis session prior to surgery and had access to the recorded script. The control arm received hypnosis education only. The primary outcome was opioid use in milligram oral morphine equivalents per 24 hours during hospital admission. A secondary analysis was performed for patients taking opioids preoperatively.

Results

64 primary knee arthroplasty patients were randomized 1:1 to hypnosis (n=31) versus control (n=33) and included in the intent-to-treat analysis. The mean (SD) postoperative opioid use in oral morphine equivalents per 24 hours was 70.5 (48.4) in the hypnosis versus 90.7 (74.4) in the control arm, a difference that was not statistically significant (difference −20.1; 95% CI −51.8 to 11.4; p=0.20). In the subgroup analysis of the opioid-experienced patients, there was a 54% daily reduction in opioid use in the hypnosis group (82.4 (56.2) vs 179.1 (74.5) difference of −96.7; 95% CI -164.4 to –29.0; p=<0.01), equivalent to sparing 65 mg of oxycodone per day.

Conclusion

Perioperative hypnosis significantly reduced inpatient opioid use among opioid-experienced patients only. A larger study examining these findings is warranted.

Trial registration number

NCT03308071.
Evolution of cooperation with time-varying tags and heterogeneous immigration dynamics
Authors: Jeong Wonhee , Hadzibeganovic Tarik , Yu Unjong
Published: June 2022

Cooperation in an open dynamic system fundamentally depends upon information distributed across its components. Yet in an environment with rapidly evolving complexity, this information may need to change adaptively to enable cooperative interactions. Combining the methods of evolutionary game theory, agent-based simulation, and statistical physics, we develop a model of the evolution of cooperation in an ageing population of artificial decision makers playing spatial tag-mediated prisoner’s dilemma games with their ingroup neighbors and with genetically unrelated immigrant agents. We introduce the concept of time-varying tags such that the phenotypic features of ‘new’ agents can change into ‘approved’ following variable approval times. In the standard 4-strategy model with fixed tags, we identified a critical cost [Formula: see text] above which cooperation transitioned abruptly into the phase of pure defection. In our generalized 6-strategy model with time-varying tags, the maintenance of elevated cooperation was observed for a much wider region of the parameter space, peaking at intermediate approval times and cost values above [Formula: see text]. Our findings reveal the existence of optimal approval times leading to high levels of cooperation if a fraction of the population adopts the strategy with an egalitarian generosity directed towards both native and approved agents, regardless of their actual origin.