bluuebunny/crossref_metadata_2025 huggingface dataset:
Feasibility of controlling hepatitis E in Jiangsu Province, China: a modelling study
Authors: Yang Meng , Cheng Xiao-Qing , Zhao Ze-Yu , Li Pei-Hua , Rui Jia , Lin Sheng-Nan , Xu Jing-Wen , Zhu Yuan-Zhao , Wang Yao , Liu Xing-Chun , Luo Li , Deng Bin , Liu Chan , Huang Jie-Feng , Yang Tian-Long , Li Zhuo-Yang , Liu Wei-Kang , Liu Wen-Dong , Zhao Ben-Hua , He Yue , Yin Qi , Mao Si-Ying , Su Yan-Hua , Zhang Xue-Feng , Chen Tian-Mu
Published: June 2021

Background

Hepatitis E, an acute zoonotic disease caused by the hepatitis E virus (HEV), has a relatively high burden in developing countries. The current research model on hepatitis E mainly uses experimental animal models (such as pigs, chickens, and rabbits) to explain the transmission of HEV. Few studies have developed a multi-host and multi-route transmission dynamic model (MHMRTDM) to explore the transmission feature of HEV. Hence, this study aimed to explore its transmission and evaluate the effectiveness of intervention using the dataset of Jiangsu Province.

Methods

We developed a dataset comprising all reported HEV cases in Jiangsu Province from 2005 to 2018. The MHMRTDM was developed according to the natural history of HEV cases among humans and pigs and the multi-transmission routes such as person-to-person, pig-to-person, and environment-to-person. We estimated the key parameter of the transmission using the principle of least root mean square to fit the curve of the MHMRTDM to the reported data. We developed models with single or combined countermeasures to assess the effectiveness of interventions, which include vaccination, shortening the infectious period, and cutting transmission routes. The indicator, total attack rate (TAR), was adopted to assess the effectiveness.

Results

From 2005 to 2018, 44 923 hepatitis E cases were reported in Jiangsu Province. The model fits the data well (R2 = 0.655, P < 0.001). The incidence of the disease in Jiangsu Province and its cities peaks are around March; however, transmissibility of the disease peaks in December and January. The model showed that the most effective intervention was interrupting the pig-to-person route during the incidence trough of September, thereby reducing the TAR by 98.11%, followed by vaccination (reducing the TAR by 76.25% when the vaccination coefficient is 100%) and shortening the infectious period (reducing the TAR by 50.05% when the infectious period is shortened to 15 days).

Conclusions

HEV could be controlled by interrupting the pig-to-person route, shortening the infectious period, and vaccination. Among these interventions, the most effective was interrupting the pig-to-person route.

Graphic Abstract
Deterministic, random, or in between? Inferring the randomness level of wildlife movements
Authors: Goicolea Teresa , Gastón Aitor , Cisneros-Araujo Pablo , García-Viñas Juan Ignacio , Mateo-Sánchez M. Cruz
Published: June 2021

Background

When assessing connectivity, it is crucial to rely on accurate modeling frameworks that consider species movement preferences and patterns. One important aspect is the level of randomness or unpredictability in the route selection. In this respect, traditional approaches (based on least-cost path or circuit theory) consider species movements unrealistically as totally deterministic or as totally random. A recent approach (randomized shortest path) advocates for choosing intermediate levels of randomness through a single parameter. This parameter may be optimized by validating connectivity surfaces developed from different levels of randomness against observed movement data. However, connectivity models are seldom validated, and it is still unclear how to approach this task. To address this knowledge gap, this paper aims at comparing different validation methods to infer the optimal randomness level in connectivity studies. Additionally, we aimed to disentangle the practical consequences of applying traditional connectivity approaches versus using an optimized level of movement randomness when delineating corridors.

Methods

These objectives were accomplished through the study case of the Iberian lynx, an endangered species whose maintenance and recovery depend on the current connectivity among its population nuclei. We firstly determined a conductance surface based on point selection functions accounting for the behavioral state (territorial or exploratory) of individuals. Secondly, we identified the level of randomness that better fits lynxes’ movements with independent GPS locations and different validation techniques. Lastly, we delineated corridors between lynx population nuclei through a) the randomized shortest path approach and the extreme and optimal levels of randomness of each validation method, and b) the traditional connectivity approaches.

Results

According to all used validation methodologies, models with intermediate levels of randomness outperformed those with extreme randomness levels representing totally deterministic or random movements. We found differences in the optimal randomness level among validation methods but similar results in the delineation of corridors. Our results also revealed that models with extreme randomness levels (deterministic and random walk) of the randomized path approach provided equivalent corridor networks to those from traditional approaches. Moreover, these corridor networks calculated with traditional approaches showed notable differences in patterns from the corridor network calculated with an optimized randomness level.

Conclusions

Here we presented a connectivity model with a solid biological basis that calibrates the level of movement randomness and is supported by comprehensive validation methods. It is thus a step forward in the search and evaluation of connectivity approaches that lead to improved, efficient, and successful management actions.
High philopatry rates of Yellow-legged Gulls in the southeastern part of the Bay of Biscay
Authors: Delgado Sergio , Herrero Alfredo , Aldalur Asier , Arizaga Juan
Published: June 2021

Background

Philopatry rate is one of the main factors shaping population dynamics in colonial seabirds. Low rates of philopatry are linked to populations with high dispersal, while high rates are linked to populations with a very high spatial structure pattern (i.e., metapopulations). The Cantabrian Yellow-legged Gull (Larus michahellis) population is considered to be resident, with relatively low dispersal rates. Precise estimations of its philopatry rates are however still lacking. Here, we aimed to estimate philopatry rates in the main Yellow-legged Gull colonies of the province of Gipuzkoa, in the southeastern part of the Bay of Biscay.

Methods

We analysed 734 resightings, during the breeding season at the colonies of Getaria, Santa Clara and Ulia, relative to a total of 3245 individuals ringed at birth in these same colonies during a period of 13 years. These data were analysed using Multi-State Recapture models in MARK.

Results

After controlling survival and resighting probability, the average dispersal rate among colonies was 4% (± SD = 2%) when individuals are immature, decreasing to 1 ± 1%) for adult breeding gulls (i.e., philopatry rate was 99%). Annual survival rates were assessed to be 0.27 ± 0.02 for birds in their first year of life and 0.87 ± 0.01 for older individuals. The probability of observing immature birds in the colonies was 0.08 ± 0.01, as compared to 0.21 ± 0.02 in adult birds.

Conclusions

We obtained evidence of extremely high local philopatry rates, clearly within the upper limit found in gulls. A high philopatry favour a speciation in these species who are vulnerable to obtain the main food source (landfills and fishing discard) which are transforming under new ecological process.
The value of involving patients and public in health services research and evaluation: a qualitative study
Authors: Saini Pooja , Hassan Shaima M. , Morasae Esmaeil Khedmati , Goodall Mark , Giebel Clarissa , Ahmed Saiqa , Pearson Anna , Harper Lesley M. , Cloke Jane , Irvine Jenny , Gabbay Mark
Published: June 2021

Background

Public and Patient Involvement, Engagement and Participation research encompasses working with patients/service users (people with a medical condition receiving health service treatment), public members, caregivers and communities (who use services or care for patients). The Partner Priority Programme (PPP) was developed by the National Health Service [NHS] and National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care [NIHR CLAHRC] NWC to share information and experience on evaluating new services being offered to patients that were seeking to reduce health inequalities, improve people’s health and wellbeing and reduce emergency hospital admissions. This paper seeks to explore an approach developed for involving the public as equal partners within the evaluation and decision-making processes of health and social care services research. The aim of this study was to identify how public advisors were included, the impact of their involvement, and how change occurred within the organisations following their involvement.

Methods

A qualitative approach using focus group discussions was adopted to explore the experiences of two cohorts of participants involved in PPP project teams. Focus groups were held with public advisors (n = 9), interns (n = 9; staff or public who received a funded internship for a PPP project), NHS and Local Authority initiative leads (n = 10), and academic facilitators (n = 14). These were transcribed verbatim and analysed using a thematic approach.

Results

Thirty-two public advisors were recruited to support 25 PPP projects across the Collaboration for Leadership in Applied Health Research and CLAHRC North West Coast [NWC] partner organisations. Three inter-related themes were conceptualised: 1)“Where it all started - involving public advisors” identified the varying journeys to recruitment and experiences of becoming a public advisor; 2)“Steps toward active involvement and engagement” related to public advisors becoming core team members; and 3) “Collaborative working to enhance public and patient involvement” relayed how projects identified the benefits of working jointly with the public advisors, particularly for those who had not experienced this style of working before.

Conclusions

The findings indicate that the PPP model is effective for embedding Public and Patient Involvement [PPI] within health services research, and recommends that PPI is integrated at the earliest opportunity within research projects and service evaluations through the use of support-led and facilitative programmes.
Surgical site, gender, and place of residence influence the time to resume driving after total joint arthroplasty
Authors: Lazar Tiberiu-Adrian , Edelmann Martin , Awiszus Friedemann , Lohmann Christoph H.
Published: June 2021

Background

For a large proportion of the population, especially those residing in the countryside, the use of a car for daily activities is indispensable. Following a TKA or THA procedure, the overseeing physician will usually recommend refraining from driving, sometimes up to 12 weeks after surgery with a major social and economical impact on patient’s life.

Objective

Considering the legal stipulations in Germany regarding fitness to drive a motor vehicle, the aim of this study is to determine the time point when patients after total knee arthroplasty (TKA) or total hip arthroplasty (THA) take up driving again postoperatively. Further, we assessed the replaced joint, side, gender, place of residence and physician’s recommendations influencing the patient in making the decision to start driving again.

Methods

92 eligible participants, contained within the frame of a prospective experimental observational study, were contacted via telephone 12 weeks after surgery and interviewed using a structured questionnaire. The answers were statistically analysed using SPSS® Version 26 for Windows.

Results

Male participants resumed driving between the 6th and 7th week post-surgery, female participants resumed driving between the 8th and 9th week post-surgery. For 58.6% of patients the reason for the first post-operative use of a vehicle was medical: the journey to physical therapy or to a doctor’s appointment. There were statistically significant differences regarding operated side, gender and place of residence. TKA impaired patients the most. Patients recovering from a TKA drove considerably later. Patients recovering from a right sided TKA had an increased risk (9 times) not to become an “early driver”. Female patients who underwent TKA had an increased risk by a factor of 21 of becoming a “late driver”. In the ageing population, surgeons, physical therapists and rehabilitation professionals need to consider new approaches in providing options for patients’ mobility. Interestingly, there is a different need for early use of own vehicle in rural regions whereas in cities patients start driving later. There are clear differences between gender and surgical site.

Conclusions

The rehabilitation following a right sided TKA proved a challenge with regard to the reuptake of driving. This should be taken into account when planning the course of therapy for patients who are driving regulary. Female patients could benefit from special training.

Trial registration

retrospectively registered, DRKS00018693 https://www.drks.de/drks_web/navigate.do?navigationId=trial. HTML&TRIAL_ID=DRKS00018693.
Symptoms, impacts, and suitability of the Pulmonary Arterial Hypertension – Symptoms and Impact (PAH-SYMPACT™) questionnaire in patients with chronic thromboembolic pulmonary hypertension (CTEPH): a qualitative interview study
Authors: Currie Brooke , Davies Evan , Beaudet Amélie , Stassek Larissa , Kleinman Leah
Published: June 2021

Background

Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare form of pulmonary hypertension caused by blood clots and scar tissue in the blood vessels of the lungs. Health-related quality of life is often significantly impaired in patients with CTEPH. However, a better understanding of how CTEPH symptoms affect patients’ lives is needed to optimally assess the impact of the disease and treatment.

Objectives

This qualitative study aimed to better understand the symptoms of CTEPH and how they affect patients’ lives, as well as to determine the appropriateness of the Pulmonary Arterial Hypertension – Symptoms and Impact (PAH-SYMPACT™) questionnaire for use in this patient population.

Methods

Adults diagnosed with CTEPH, recruited from two clinical sites in the US, participated in one-to-one qualitative telephone interviews. They described their experience of CTEPH symptoms and the impact these symptoms have on their lives. They also provided feedback on the comprehensibility and relevance of the PAH-SYMPACT™‘s instructions, items, and response options.

Results

Participants (N = 12) had a mean age of 62.5 years. Two thirds were female and most (83%) had undergone pulmonary endarterectomy and/or balloon pulmonary angioplasty. The most frequently endorsed symptoms were shortness of breath (endorsed by all 12 participants), fatigue (11 participants), and lightheadedness (10 participants). All participants identified shortness of breath as an “extremely important” symptom, and seven participants rated fatigue as “extremely important.” The most frequent impacts of CTEPH were on ability to walk quickly (endorsed by all 12 participants), ability to walk up inclines or stairs (11 participants), and ability to carry things (11 participants). The PAH-SYMPACT™ items were relevant to most participants and reflected their experience of CTEPH. All participants indicated that no important CTEPH symptoms were missing from the PAH-SYMPACT™. Overall, the instructions, items, and response options of the PAH-SYMPACT™ were clear and easy to understand.

Conclusions

The symptoms and impacts experienced by patients with CTEPH align with items included in the PAH-SYMPACT™. The PAH-SYMPACT™ appears to be fit for purpose for assessing disease status in patients with CTEPH.
Case reports of cerebral sinus venous thrombosis in COVID-19 patients
Authors: Sitanggang Prysta Aderlia , Tini Kumara , Susilawathi Ni Made , Wijayanti Ida Ayu Sri , Dewi Putu Utami , Samatra Dewa Putu Gde Purwa
Published: June 2021

Background

Coronavirus disease 2019 (COVID-19) pandemic has started in December 2019 and still ongoing. The disease has been expanding rapidly with a high variety of phenotypes from asymptomatic, mild respiratory tract infection, multiple organ system dysfunction, and death. Neurological manifestations also appear in patients with COVID-19, such as headache, seizures, a decrease of consciousness, and paralysis. The hypercoagulable state in patients with COVID-19 is associated with the thromboembolic incident including ischemic strokes, venous thromboembolism, pulmonary artery embolism, and many further. Cerebral sinus venous thrombosis (CSVT) is a rare neurovascular emergency that is often found in critically ill patients. We report two cases of CSVT with different onsets, neurologic manifestations, and prognoses.

Case presentation

Two cases of cerebral sinus venous thrombosis in COVID-19 patients were reported, following respiratory, hematology, and coagulation disarrangements, which was triggered by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The first patient, which was presented with a seizure, had hypertension and diabetes mellitus as comorbidities. The latter case had no comorbidity but showed more severe presentations of COVID-19 such as brain and lung thrombosis, although already had several days of intravenous anticoagulant administrations. These two cases also have a different course of disease and outcomes, which were interesting topics to study.

Conclusions

CSVT is one of the neurological complications of the COVID-19 when the brainstem venous drainage is involved. Despite successful alteration to the negative result of SARS-CoV-2 through the rt-PCR test, thrombogenesis and coagulation cascade continuing. Therefore, a high level of neutrophil to lymphocyte ratio (NLR), D-dimer, fibrinogen, and C-reactive protein (CRP) are paramount indicators of poor prognosis.
Anesthesia for Transoral Endoscopic Parathyroidectomy by Vestibular Approach (TOEPVA)
Authors: YILMAZ Fulya , BAS Koray
Published: June 2021

Background

After thyroid diseases, hyperparathyroidism is one of the most common endocrine surgical diseases. The increasing diagnosis of thyroid pathologies in early stages and a societal emphasis on physical appearances, especially in young women, have led to the development of new surgical techniques alternative to conventional transcervical incision consistently. Here, we describe our anesthesia experience for parathyroidectomy with Transoral Endoscopic Parathyroidectomy by Vestibular Approach (TOEPVA). Patients who undergo TOEPVA at our institution between November 2018 and April 2019 were reviewed. Demographic data and hemodynamic parameters were reported.

Results

Seven patients were operated successfully by this technique, none of which required conversion to conventional open surgery. Two patients required atropine and one patient required ephedrine during insufflation.

Conclusion

After induction of anesthesia with propofol, remifentanil, and rocuronium and anesthesia managed by desflurane co-administered with continuous infusion of remifentanil provide feasible and safe anesthesia for TOEPVA. However, especially during hydrodissection and insufflation, a close cooperation between surgeon and anesthetist has a great value to improve patient management.
Serum level of cytokeratin 19 as a diagnostic and prognostic marker in patients with HCV-related hepatocellular carcinoma
Authors: El Raziky Maissa , Abdel Hafez Hanan , Elsharkawy Aisha , Moneer Tarek Ahmed , EL-Sheikh Suzan M. , Maher Rabab M. , Sharaf Sahar A.
Published: June 2021

Background

The heterogeneous nature of human hepatocellular carcinoma (HCC) impedes both treatment strategies and prognostic predictions. Several markers have been proposed for the diagnosis of HCC. Cytoskeleton-associated proteins have been known as cellular integrators in neoplasm formation. Hepatic progenitor cells are thought to express alpha-fetoprotein (AFP) and hematopoietic as well as biliary markers such as cytokeratin 19 (CK 19) and cytokeratin 7. The aim of this study was to verify the role of serum CK 19 alone or in combination with AFP as a diagnostic marker of HCC and to assess the changes in its levels after ablation of HCV-related HCC to evaluate its role as a predictor marker for recurrence of HCC after ablation. The study was conducted on 102 HCV-related cirrhotic patients categorized into three different groups according to the clinical, laboratory, and radiological evaluation: group I—62 patients with early or intermediate HCC who underwent locoregional intervention, group II—20 patients with advanced HCC not fit for any intervention apart from best supportive treatment, and group III—20 cirrhotic patients with no evidence of HCC as proved by two imaging techniques.

Results

The mean serum levels of CK 19 were 6.5 ± 5.7, 10.5 ± 12.5, and 6.8 ± 2.8 ng/ml in groups I, II, and III, respectively, with no significant difference between groups. Sensitivity, specificity, positive, and negative predictive values of combined AFP and human CK 19 at cutoff levels of 25.5 ng/ml and 6.25 ng/ml were 93.9%, 45%, 87.5%, and 64.3%, respectively. In group I patients, CK 19 levels were comparable in patients with ablated focal lesion and those who did not at baseline; then, it was significantly higher in ablated patients than in patients with residual tumor 1 and 6 months after the intervention.

Conclusions

Combination of both AFP and CK 19 levels could increase the diagnostic accuracy of suspected HCCs. CK 19 levels are good predictors of ablation/recurrence in patients who underwent interventional procedures minimizing the need for follow-up imaging modalities.
Screening and assessment of molecular mechanistic actions of 5-hydroxy-1-methylpiperidin-2-one against free radicals, lung cancer cell line (A549), and binding properties on bovine serum albumin
Authors: Yadav Sangilimuthu Alagar , Faruck Lukmanul Hakkim , Subramanium Rajagopal , Surendren Lakshmi K. , Bakshi Hamid
Published: June 2021

Background

Natural products play a key role in treating different ailment including diabetes, asthma, skin diseases, and cancer. It is well known that synthetic drugs elicit significant toxicity when used in the clinic. A higher drug affinity towards carrier protein Bovine Serum Albumin (BSA) would enhance a higher drug bioavailability which in turn leads to a higher therapeutic efficacy. The focus of the present study was to investigate antioxidant and anti-cancer potential of 5-hyrdoxy1-methylpiperidin-2-one (5-HMP) isolated from leaves ofTragia involucrata.

Methods and material

In vitro free radical scavenging assays and MTT assay were employed to assess the antioxidant activity of 5-HMP and cytotoxicity of 5-HMP on lung cancer cell line, A549, respectively. In addition, attempts were made to investigate 5-HMP binding capacity on BSA by spectral studies and molecular docking.

Results

The antioxidant data revealed that 5-HMP inhibited the radicals with an IC50value of 49.55 ± 0.75 μg/ml which was comparable with the IC50values afforded byl-ascorbic acid. 5-HMP exhibited a dose-dependent cytotoxicity on A549 cells with an IC50value of 30.00 ± 0.55 μg/ml. further 5-HMP induced a cell cycle arrest in A549 at S and G2/M phase. The fluorescence quenching was observed when an increasing concentration of 5-HMP, reacts with a fixed concentration of BSA (1.0 μM). The fluorescence quenching of BSA by 5-HMP indicated a binding constant of K5-HMP= 2.8 ± 1.4 × 104M−1with corresponding binding free energy (ΔG)−6.06 K.cal/mole.

Conclusions

This paper concluded that 5-HMP possesses antioxidant properties, cytotoxic effects and also it possesses good drug binding properties on bovine serum albumin.
Donafenib Versus Sorafenib in First-Line Treatment of Unresectable or Metastatic Hepatocellular Carcinoma: A Randomized, Open-Label, Parallel-Controlled Phase II-III Trial
Authors: Qin Shukui , Bi Feng , Gu Shanzhi , Bai Yuxian , Chen Zhendong , Wang Zishu , Ying Jieer , Lu Yinying , Meng Zhiqiang , Pan Hongming , Yang Ping , Zhang Helong , Chen Xi , Xu Aibing , Cui Chengxu , Zhu Bo , Wu Jian , Xin Xiaoli , Wang Jufeng , Shan Jinlu , Chen Junhui , Zheng Zhendong , Xu Li , Wen Xiaoyu , You Zhenyu , Ren Zhenggang , Liu Xiufeng , Qiu Meng , Wu Liqing , Chen Feng
Published: June 2021

PURPOSE

Donafenib, a novel multikinase inhibitor and a deuterated sorafenib derivative, has shown efficacy in phase Ia and Ib hepatocellular carcinoma (HCC) studies. This study compared the efficacy and safety of donafenib versus sorafenib as first-line therapy for advanced HCC.

PATIENTS AND METHODS

This open-label, randomized, parallel-controlled, multicenter phase II-III trial enrolled patients with unresectable or metastatic HCC, a Child-Pugh score ≤ 7, and no prior systemic therapy from 37 sites across China. Patients were randomly assigned (1:1) to receive oral donafenib (0.2 g) or sorafenib (0.4 g) twice daily until intolerable toxicity or disease progression. The primary end point was overall survival (OS), tested for noninferiority and superiority. Efficacy was primarily assessed in the full analysis set (FAS), and safety was assessed in all treated patients.

RESULTS

Between March 21, 2016, and April 16, 2018, 668 patients (intention-to-treat) were randomly assigned to donafenib and sorafenib treatment arms; the FAS included 328 and 331 patients, respectively. Median OS was significantly longer with donafenib than sorafenib treatment (FAS; 12.1 v 10.3 months; hazard ratio, 0.831; 95% CI, 0.699 to 0.988; P = .0245); donafenib also exhibited superior OS outcomes versus sorafenib in the intention-to-treat population. The median progression-free survival was 3.7 v 3.6 months ( P = .0570). The objective response rate was 4.6% v 2.7% ( P = .2448), and the disease control rate was 30.8% v 28.7% (FAS; P = .5532). Drug-related grade ≥ 3 adverse events occurred in significantly fewer patients receiving donafenib than sorafenib (125 [38%] v 165 [50%]; P = .0018).

CONCLUSION

Donafenib showed superiority over sorafenib in improving OS and has favorable safety and tolerability in Chinese patients with advanced HCC, showing promise as a potential first-line monotherapy for these patients.
Maximal Fat Oxidation Rate Is Higher in Fit Women and Unfit Women With Obesity, Compared to Normal-weight Unfit Women
Authors: Frandsen Jacob , Hansen Ida Marie Dahlgaard , Wismann Julie Fensmark , Olsen Maria Høyer , Brage-Andersen Morten Runge , Sahl Ronni Eg , Hansen Maria , Ingersen Arthur , Modvig Johanne Louise , Schmücker Malte , Grauslund Camilla Honoré , Dela Flemming , Larsen Steen , Helge Jørn Wulff
Published: June 2021

Context

The maximal fat oxidation rate (MFO) is higher in aerobically fit vs unfit young men, but this training-related increase in MFO is attenuated in middle-aged men. Further, it has also been found that unfit men with obesity may have an elevated MFO compared to unfit normal-weight men.

Objective

Based hereupon, we aimed to investigate whether a fitness-related higher MFO were attenuated in middle-aged women compared to young women. Also, we aimed to investigate if unfit women with obesity have a higher MFO compared to unfit normal-weight women. We hypothesized that the training-related elevated MFO was attenuated in middle-aged women, but that unfit women with obesity would have an elevated MFO compared to unfit normal-weight women.

Methods

We recruited 70 women stratified into 6 groups: young fit (n = 12), young unfit (n = 12) middle-aged fit (n = 12), middle-aged unfit (n = 12), unfit young women with obesity (n = 12), and unfit middle-aged women with obesity (n = 10). Body composition and resting blood samples were obtained and MFO was measured by a graded exercise test on a cycle ergometer via indirect calorimetry. Subsequently, a maximal exercise test was performed to establish peak oxygen uptake (V̇O2peak).

Results

Young and middle-aged fit women had a higher MFO compared to age-matched unfit women, and young fit women had a higher MFO compared to fit middle-aged women. Unfit women with obesity, independent of age, had a higher MFO compared to their normal-weight and unfit counterparts.

Conclusion

The training-related increase in MFO seems maintained in middle-aged women, and we find that unfit women with obesity, independent of age, have a higher MFO compared to unfit normal-weight women.
Longitudinal Metabolic Profiling of Maternal Obesity, Gestational Diabetes, and Hypertensive Pregnancy Disorders
Authors: Kivelä Jemina , Sormunen-Harju Heidi , Girchenko Polina V , Huvinen Emilia , Stach-Lempinen Beata , Kajantie Eero , Villa Pia M , Reynolds Rebecca M , Hämäläinen Esa K , Lahti-Pulkkinen Marius , Murtoniemi Katja K , Laivuori Hannele , Eriksson Johan G , Räikkönen Katri , Koivusalo Saila B
Published: June 2021

Context

Comprehensive assessment of metabolism in maternal obesity and pregnancy disorders can provide information about the shared maternal-fetal milieu and give insight into both maternal long-term health and intergenerational transmission of disease burden.

Objective

To assess levels, profiles, and change in the levels of metabolic measures during pregnancies complicated by obesity, gestational diabetes (GDM), or hypertensive disorders.

Design, Setting and Participants

A secondary analysis of 2 study cohorts, PREDO and RADIEL, including 741 pregnant women.

Main Outcome Measures

We assessed 225 metabolic measures by nuclear magnetic resonance in blood samples collected at median 13 [interquartile range (IQR) 12.4-13.7], 20 (IQR 19.3-23.0), and 28 (27.0-35.0) weeks of gestation.

Results

Across all 3 time points women with obesity [body mass index (BMI) ≥ 30kg/m2] in comparison to normal weight (BMI 18.5-24.99 kg/m2) had significantly higher levels of most very-low-density lipoprotein-related measures, many fatty and most amino acids, and more adverse metabolic profiles. The change in the levels of most metabolic measures during pregnancy was smaller in obese than in normal weight women. GDM, preeclampsia, and chronic hypertension were associated with metabolic alterations similar to obesity. The associations of obesity held after adjustment for GDM and hypertensive disorders, but many of the associations with GDM and hypertensive disorders were rendered nonsignificant after adjustment for BMI and the other pregnancy disorders.

Conclusions

This study shows that the pregnancy-related metabolic change is smaller in women with obesity, who display metabolic perturbations already in early pregnancy. Metabolic alterations of obesity and pregnancy disorders resembled each other suggesting a shared metabolic origin.
Shopping for Lower Sales Tax Rates
Authors: Baker Scott R. , Johnson Stephanie , Kueng Lorenz
Published: June 2021

Using comprehensive high-frequency state and local sales tax data, we show that shopping behavior responds strongly to changes in sales tax rates. Even though sales taxes are not observed in posted prices and have a wide range of rates and exemptions, consumers adjust in many dimensions. They stock up on storable goods before taxes rise and increase online and cross-border shopping in both the short and long run. The difference between short- and long-run spending responses has important implications for the efficacy of using sales taxes for countercyclical policy and for the design of an optimal tax framework. Interestingly, households adjust spending similarly for both taxable and tax-exempt goods. We embed an inventory problem into a continuous-time consumption-savings model and demonstrate that this behavior is optimal in the presence of shopping trip fixed costs. The model successfully matches estimated short-run and long-run tax elasticities. We provide additional evidence in favor of this new shopping complementarity mechanism. (JEL E21, E32, G51, H21, H25, H71)
The m6A landscape of polyadenylated nuclear (PAN) RNA and its related methylome in the context of KSHV replication
Authors: Martin Sarah Elizabeth , Gan Huachen , Toomer Gabriela , Sridhar Nikitha , Sztuba-Solinska Joanna
Published: June 2021

Polyadenylated nuclear (PAN) RNA is a long noncoding transcript involved in Kaposi's sarcoma-associated herpesvirus (KSHV) lytic reactivation and regulation of cellular and viral gene expression. We have previously shown that PAN RNA has dynamic secondary structure and protein binding profiles that can be influenced by epitranscriptomic modifications. N6-methyladenosine (m6A) is one of the most abundant chemical signatures found in viral RNA genomes and virus-encoded RNAs. Here, we combined antibody-independent next-generation mapping with direct RNA sequencing to address the epitranscriptomic status of PAN RNA in KSHV infected cells. We showed that PAN m6A status is dynamic, reaching the highest number of modifications at the late lytic stages of KSHV infection. Using a newly developed method, termed selenium-modified deoxythymidine triphosphate (SedTTP)-reverse transcription (RT) and ligation assisted PCR analysis of m6A (SLAP), we gained insight into the fraction of modification at identified sites. By applying comprehensive proteomic approaches, we identified writers and erasers that regulate the m6A status of PAN, and readers that can convey PAN m6A phenotypic effects. We verified the temporal and spatial subcellular availability of the methylome components for PAN modification by performing confocal microscopy analysis. Additionally, the RNA biochemical probing (SHAPE-MaP) outlined local and global structural alterations invoked by m6A in the context of full-length PAN RNA. This work represents the first comprehensive overview of the dynamic interplay that takes place between the cellular epitranscriptomic machinery and a specific viral RNA in the context of KSHV infected cells.
maxRatio improves the detection of samples with abnormal amplification profiles on QIAgen’s artus HIV-1 qPCR assay
Authors: Marongiu Luigi , Shain Eric B. , Martinelli Marianna , Pagliari Matteo , Allgayer Heike
Published: June 2021

Background: Accurate viral load (VL) determination is paramount to determine the efficacy of anti-HIV-1 therapy. The conventional method used, fit-point (FP), assumes an equal efficiency in the polymerase chain reaction (PCR) among samples that might not hold for low-input templates. An alternative approach, maxRatio, was introduced to compensate for inhibition in PCR.

Methods: Herein, we assessed whether maxRatio could improve VL quantification using 2,544 QIAgen artus HI virus-1 RT-PCR reactions. The assay’s standard dilutions were used to build external standard curves with either FP or maxRatio that re-calculated the VLs.

Results: FP and maxRatio were highly comparable (Pearson’s ρ=0.994, Cohen’s  κ=0.885), and the combination of the two methods identified samples (n=41) with aberrant amplification profiles.

Conclusions: The combination of maxRatio and FP could improve the predictive value of the assay.
iCAT: diagnostic assessment tool of immunological history using high-throughput T-cell receptor sequencing
Authors: Rajeh Ahmad , Wolf Kyle , Schiebout Courtney , Sait Nabeel , Kosfeld Tim , DiPaolo Richard J. , Ahn Tae-Hyuk
Published: June 2021

The pathogen exposure history of an individual is recorded in their T-cell repertoire and can be accessed through the study of T-cell receptors (TCRs) if the tools to identify them were available. For each T-cell, the TCR loci undergoes genetic rearrangement that creates a unique DNA sequence. In theory these unique sequences can be used as biomarkers for tracking T-cell responses and cataloging immunological history. We developed the immune Cell Analysis Tool (iCAT), an R software package that analyzes TCR sequencing data from exposed (positive) and unexposed (negative) samples to identify TCR sequences statistically associated with positive samples. The presence and absence of associated sequences in samples trains a classifier to diagnose pathogen-specific exposure. We demonstrate the high accuracy of iCAT by testing on three TCR sequencing datasets. First, iCAT successfully diagnosed smallpox vaccinated versus naïve samples in an independent cohort of mice with 95% accuracy. Second, iCAT displayed 100% accuracy classifying naïve and monkeypox vaccinated mice. Finally, we demonstrate the use of iCAT on human samples before and after exposure to SARS-CoV-2, the virus behind the COVID-19 global pandemic. We were able to correctly classify the exposed samples with perfect accuracy. These experimental results show that iCAT capitalizes on the power of TCR sequencing to simplify infection diagnostics. iCAT provides the option of a graphical, user-friendly interface on top of usual R interface allowing it to reach a wider audience.
The effectiveness of EMR implementation regarding reducing documentation errors and waiting time for patients in outpatient clinics: a systematic review
Authors: Albagmi Salem
Published: June 2021

Background: Electronic medical records (EMRs) refer to the digital copies of paper notes prepared in the physician’s office, outpatient clinics and other departments in health care institutes. EMRs are considered to be significant and preferable to paper records because they allow providers to keep accurate track of patient data and monitoring over time, thus reducing errors, and enhance overall health care quality. The aim of this systematic review was to highlight the significance of EMRs and the effectiveness of implementation regarding reducing documentation errors and waiting time for patients in outpatient clinics.

Methods: PubMed, Central, Ovid, Scopus, Science Direct, Elsevier, Cochrane , WHO website and the McMaster University Health Evidence website from 2005-2020 were searched to identify studies that investigated the association between the EMR implementation and documentation error and waiting time for patients. A reviewer screened identified citations and extracted data according to the PRISMA guidelines and data was synthesized in a narrative manner.

Results: After full text examination of the articles selected for this literature review, the major themes of relevance that were identified in the context of reducing documentation errors and waiting time for patients in outpatient clinic include: reduction of medical errors because of fewer documentation errors resulting from EMR implementation and reduction of waiting time for patients due to overall improvement of system workflow after use of EMRs.

Conclusion: In summary of the reviewed evidence from published material, the implementation of an EMR system in any outpatient setting appears to reduce documentation errors (medication dose errors, issues of prescription errors). It was also seen that in many settings, waiting time for patients in outpatient clinics was reduced with EMR use, while in other settings it was not possible to determine if any significant improvement was seen in this aspect after EMR implementation.
Refining the content and design of an alcohol reduction app, Drink Less, to improve its usability and effectiveness: a mixed methods approach
Authors: Garnett Claire , Perski Olga , Michie Susan , West Robert , Field Matt , Kaner Eileen , Munafò Marcus R. , Greaves Felix , Hickman Matthew , Burton Robyn , Brown Jamie
Published: June 2021

Background: Digital interventions have the potential to reduce alcohol consumption, although evidence on the effectiveness of apps is lacking. Drink Less is a popular, evidence-informed app with good usability, putting it in a strong position to be improved upon prior to conducting a confirmatory evaluation. This paper describes the process of refining Drink Less to improve its usability and likely effectiveness.

Methods: The refinement consisted of three phases and involved qualitative and quantitative (mixed) methods: i) identifying changes to app content, based on findings from an initial evaluation of Drink Less, an updated review of digital alcohol interventions and a content analysis of user feedback; ii) designing new app modules with public input and a consultation with app developers and researchers; and iii) improving the app’s usability through user testing.

Results: As a result of the updated review of digital alcohol interventions and user feedback analysis in Phase 1, three new modules: ‘Behaviour Substitution’, ‘Information about Antecedents’ and ‘Insights’, were added to the app. One existing module – ‘Identity Change’ – was removed based on the initial evaluation of Drink Less. Phases 2 and 3 resulted in changes to existing features, such as improving the navigational structure and onboarding process, and clarifying how to edit drinks and goals.

Conclusions: A mixed methods approach was used to refine the content and design of Drink Less, providing insights into how to improve its usability and likely effectiveness. Drink Less is now ready for a confirmatory evaluation.
Occupational therapy and Beery VMI scores of children with autism spectrum disorder, brachial plexus injury, and cerebral palsy
Authors: Carsone Blair , Green Katherine , Torrence William , Henry Bridgett
Published: June 2021

Data of 107 children (84 males and 23 females) who received occupational therapy services were collected. Data collected included age, gender, prescribed frequency of occupational therapy, number of sessions attended within the six-month timeframe, pre and post Beery Visual Motor Integration scores.
Approaches for containerized scientific workflows in cloud environments with applications in life science
Authors: Spjuth Ola , Capuccini Marco , Carone Matteo , Larsson Anders , Schaal Wesley , Novella Jon Ander , Stein Oliver , Ekmefjord Morgan , Tommaso Paolo Di , Floden Evan , Notredame Cedric , Moreno Pablo , Hellander Andreas , Khoonsari Payam Emami , Herman Stephanie , Kultima Kim , Lampa Samuel
Published: June 2021

Containers are gaining popularity in life science research as they provide a solution for encompassing dependencies of provisioned tools, simplify software installations for end users and offer a form of isolation between processes. Scientific workflows are ideal for chaining containers into data analysis pipelines to aid in creating reproducible analyses. In this article, we review a number of approaches to using containers as implemented in the workflow tools Nextflow, Galaxy, Pachyderm, Argo, Kubeflow, Luigi and SciPipe, when deployed in cloud environments. A particular focus is placed on the workflow tool’s interaction with the Kubernetes container orchestration framework.
The genome sequence of the ringlet, Aphantopus hyperantus Linnaeus 1758
Authors: Mead Dan , Saccheri Ilik , Yung Carl J. , Lohse Konrad , Lohse Carla , Ashmole Philip , Smith Michelle , Corton Craig , Oliver Karen , Skelton Jason , Betteridge Emma , Quail Michael A. , Dolucan Jale , McCarthy Shane A. , Howe Kerstin , Wood Jonathan , Torrance James , Tracey Alan , Whiteford Sam , Challis Richard , Durbin Richard , Blaxter Mark
Published: June 2021

We present a genome assembly based on an individual female Aphantopus hyperantus, also known as Maniola hyperantus (the ringlet butterfly; Arthropoda; Insecta; Lepidoptera, Nymphalidae), scaffolded using data from a second, unrelated specimen. The genome sequence is 411 megabases in span. The majority of the assembly is scaffolded into 29 chromosomal pseudomolecules, including the Z sex chromosome.
Cardiology is where my heart is
Authors: Barton Carys
Published: June 2021

Carys Barton, heart failure nurse consultant, Chair of the British Society for Heart Failure Nurse Forum and Lynda Blue award nominee, discusses her career to date, her role as a consultant nurse, and the importance of mentors, the multidisciplinary team and learning from patients in achieving your goals.
Perceptions of fatigue and fatigue management interventions among people with multiple sclerosis: a systematic literature review and narrative synthesis
Authors: Power Míde , Arafa Nora , Wenz Anke , Foley Geraldine
Published: June 2021

Background/Aims

Fatigue is the most common symptom of multiple sclerosis. Evidence supports the effectiveness of fatigue management interventions for people with multiple sclerosis. This review aimed to identify how people with multiple sclerosis experience fatigue and to examine their perceptions of fatigue management interventions.

Methods

The review was conducted systematically, searching the following electronic databases: AMED, CINAHL Complete, eBook Nursing Collection, ERIC, Health Source: Nursing/Academic Edition, MEDLINE, APA PsycArticles, and APA PsycInfo for original peer-reviewed empirical research published in English between January 2000 and June 2020. Qualitative and mixed-methods studies that captured the perspectives of people with multiple sclerosis on their fatigue and/or their perceptions of fatigue management interventions were included. A narrative synthesis was used to synthesise the findings.

Results

A total of 23 qualitative and eight mixed-methods studies were extracted comprising a total of 662 people with multiple sclerosis (relapsing remitting n=293; secondary progressive n=129; primary progressive n=73; relapsing progressive n=3; benign n=2; fulminant n=1; type of multiple sclerosis not reported n=161). Fatigue was perceived by people with multiple sclerosis as a debilitating symptom of the condition and which they felt impacted adversely on their lives. A lack of understanding from others about multiple sclerosis fatigue was challenging for people with multiple sclerosis. People with multiple sclerosis valued the physical and psychosocial-based content of fatigue management interventions and felt fatigue management interventions enabled them to legitimise their fatigue and feel more in control of their fatigue.

Conclusions

From the perspective of people with multiple sclerosis, fatigue is a central and debilitating feature of the everyday experience of living with multiple sclerosis. Research on the potential of fatigue management interventions to foster control for people with multiple sclerosis to help them manage their fatigue is warranted. Healthcare professionals should consider how they can empower people with multiple sclerosis to educate others about their fatigue. Some evidence being generated for practice might not be sufficiently contextualised to different forms of multiple sclerosis.
The Perceptions of Culturally Diverse Graduate Students on Multicultural Education: Implication for Inclusion and Diversity Awareness in Higher Education
Authors: Doucette Brenda , Sanabria Alyssa , Sheplak Ashley , Aydin Hasan
Published: June 2021

Multicultural education improves educators’ understanding of the complexities of different cultures and the inherent intersectionality of race, gender, class, and exceptionality to liberate students from oppressive structures within society. The purpose of this study is to illuminate the perceptions of educational leadership graduate students regarding multicultural education and transformative leadership through the lens of critical pedagogy. During this qualitative case study, the researchers used course materials, including discussion and responses, book reviews, and presentations, to answer these research questions: What factors drove the graduate students to want to seek out further experiences for them or their students with multicultural education? What did the participants perceive as potential barriers to influencing educational reform? In what ways did the perceptions of the graduate students regarding multicultural education change over the course of a semester? Three themes emerged from the analysis, the illusion of inclusivity, cultural awareness, and the disconnection between theory and practice. This research could impact current and potential future educational leaders and provides information that would benefit school districts, teachers, and students.